He is 78 years old and one of my favorite patients. A very sweet, gentle and pleasant man. He is never any problem to care for. He is totally compliant with his diet and fluid restrictions. We never have to take more than 2 kg off of him at a time. He is the perfect patient. He has never given me any indication of being acutely ill. His history shows having a CABG in 1987 and no problems since then.
Monday, he drove himself to treatment, walked into the clinic by himself, had no complaints of feeling ill. His heart and lungs sounded great. 57 minutes into his treatment and after removing only 0.8 kg, he arrested. Just like that. One minute he is fine, the next minute he is technically dead.
We started CPR and put on the AED until the paramedics arrived (10 minutes later!). The AED said no shockable rhythm, continue CPR. For 10 minutes I did compressions on that man. The paramedics arrive and someone says, "Lori, Mr. so-and-so is here and needs to be put on." So I'm right back into the dialysis "dance" for the rest of the day. We had no idea if he made it or not.
I stopped by the hospital after my shift to see if he had made it. He did make it, and more importantly, he is alert, following directions and recognizes me. He is neurologically intact! He is expected to make a full recovery.
I once was a firefighter/EMT and I've performed CPR before. Usually on people who have been down who knows how long. They never made it. They were strangers to me. This man: I have a relationship with. This was different. I have been a nurse for almost 19 years and I have never had a patient code right in front of me. I've taken CPR classes year after year to make sure I was prepared, and to be honest, the last few times I didn't take them too seriously 'cuz "I've been there, done that." Those "mock codes", that I once thought of as rediculously a waste of time are no longer going to be looked on with disdain. Today I'm glad I was prepared. I saved a man's life. God, it feels great to be a nurse! I've made a differnce.
Of all my dialysis patients, this man was not the one I expected to code. He was "stable". It can happen to anyone, at anytime. It pays to be prepared.
