My first code ever...(any ideas on what happened?)

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Specializes in LDRP.

Pt was 70+ year old female. +MI. was having unstable angina monday night, fine on tuesday, no angina, no probs with vitals, etc. had cath wed (today) AM. some disease, no intervention necessary (also has ef of 25%)

went thru her post cath frequent vitals withflying colors. BP's 100's-130 systolic. cath site without complications. never felt dizzy, lightheaded, etc. (i asked) helped her OOB at 345pm. did ok. into chair. c/o constipation, no BM since sunday. gave milk of mag with dinner. her md was in at 1800 to see her.

at 1908-calls out, c/o nausea

at 1909-HR from 60s to 30s. me and another RN start walking down the hall to check on her.

1910-they yell "she's in asystole" to which we go running down the hall, find her in the chair, unresponsive. the 4 of us throw her back in bed,which woke her up. bp fine, cath site still fine. said she started to feel cool and lightheaded and that was it.

my question-

what could have caused this? her vitals were fine all day, cath site fine, no pain, nothing. i just wonder if i missed something.

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Specializes in School Nursing.

Hello,

Just wondering if this was considered a "code" ??

Sounds like certainly a cause for concern, but was a "code" team called in for this incidence?

LPN 90

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Specializes in LDRP.

we hit the code button, then cancelled it once she came around.

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vaso vagal response?

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Specializes in Nurse Scientist-Research.
vaso vagal response?

That's what I was thinking also taking account that this lady has a poopy heart to start with.

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got to abe the vaso vagal response, she was constipated maybe flet she needed to pass gas and when she attempted to...well you know what happened next.:nurse:

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Specializes in OB/GYN,L&D,FP office,LTC.

Did your pt get up to the bathroom? Do you think she was straining to have a B

M?

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Specializes in tele, stepdown/PCU, med/surg.

Vaso-vagaled. In my experience, people who do this or have a sudden drop of BP can be unresponsive for like 30 seconds. What's their BP/HR stabilizes, they come back. It's still very scary and for people who are newly unresponsive with signs of possible cardiovascular collapse, a code should be called even if its subsequently cancelled.

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Specializes in Gerontological, cardiac, med-surg, peds.

If she had an inferior MI (as older females tend to do), she may have damaged the conduction system (SA node), which would also make her more prone for brady/ asystole, especially with any vaso-vagal stimulation. I would carefully investigate her medications (especially beta-blockers, calcium channel blockers).

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Specializes in CCU/CVU/ICU.

Yep everyone is right. She vagaled, probably because she 'wretched/dry-heaved' because of the nausea.

I once responded to an code where pt was in asystole, got rate back...transferred the guy down to the unit. He had asystolic 'code' 2 more times...got him back. NUrse disimpacted the guy after discovering she needed to :) He did fine after that . So, basically, the guy kept coding(vagaling) because he had to poop/was impacted...got him a stay in icu.

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