New LVN concerned about Code and STAT response.

[pageturnstyle]

I've been an LVN for about 2 months now in LTC, and for the most part I'm getting the hang of my job. Today, however, I experienced my first emergency. One of my residents collapsed in physical therapy, her B/P and O2 plummeted, and she was briefly unresponsive. The physical therapist ran up to me and told me to call a STAT and then ran back to my resident. I have to admit I was confused and caught off guard. This may be a stupid question but how do you call a STAT or a Code in a nursing home? What does one say over the intercom of a nursing home to maintain calm and privacy while indicating you need the immediate assistance of other nurses? Any tips from LTC nurses would be greatly appreciated.

[Blackcat99]

I have worked in many LTC's in the past. We never had anything like calling a code or stat response over the intercom. If a patient was in trouble, we would just run and get someone on the floor to help or call 911.

[TheCommuter, BSN, RN]

"CODE BLUE to the rehab gym. . ."

This always works like a charm when I announce it over the paging system.

[aspyer]

Your facility should have protocols in place for such procedures this will usually be a code blue and give your location.Usually part of the orientation process. Hope everything worked out well for the resident.

[cardiacnurse34]

Check with your facilities protocols. Usually you assess the pt yourself. Always check the BP and glucose 1st thing. Tell a CNA to bring the DON or ADON.

[Amber Lynn]

Wow. Your facility should have taught you that in the training process. Shame on them. I'm not sure how to answer your question because I work assisted living and I'm sure every facility is different.

Emergency situations are always stressful and I still always get nervous in them.

Make sure you go over your questions with your supervisor.

[Lexxie, LPN]

I would also check to see which residents are full codes vs. DNR or have living wills. In the LTC facility that I worked at, those things ultimately determined what was done in a emergency situation, ie: 911 call or comfort measures.

[OgopogoLPN, LPN, RN]

We do not have code blues at LTC here. CPR is not offered or administered in LTC. The resident and their family decides on a level of intervention and if they want CPR started or not if an ambulance is called. 95% say "NO" to CPR.

If someone is in acute distress, first I look up their level of intervention. If they are supportive measures only, they do not go to acute care, unless we cannot control their pain/suffering at the facility. They are typically a DNR and want comfort care only.

If someone is a level 2 or 3, (and cognitive), they will be asked if they want to go to the hospital. If they are not cognitive, their NOK will be phoned and asked. These ones usually do go and have some degree of life preserving interventions (IV abx, surgery, intubation, etc)

[NamasteNurse, BSN, RN]

" CPR is not offered or administered in LTC " This may be true where you work, but it is NOT true for all LTC facilities.

Residents and their families make that decision on admission and it is an ongoing conversation. Most facilities have some sort of identification system to determine CPR or DNR.

Also remember that DNR does NOT mean do not treat, the response with this quote in it sounded like it was no big deal and if you're not going to do CPR, then there's nothing to do. We still do everything to treat the 'collapsed' patient like give O2 or a nebulizer tx.

[OgopogoLPN, LPN, RN]

" CPR is not offered or administered in LTC " This may be true where you work, but it is NOT true for all LTC facilities.

Residents and their families make that decision on admission and it is an ongoing conversation. Most facilities have some sort of identification system to determine CPR or DNR.

Also remember that DNR does NOT mean do not treat, the response with this quote in it sounded like it was no big deal and if you're not going to do CPR, then there's nothing to do. We still do everything to treat the 'collapsed' patient like give O2 or a nebulizer tx.

No, I didn't say it was for LTC everywhere. I said it was for where I work. And I also didn't stated that DNR meant no treatment. I said we sent them to acute care if we could not allieviate their pain/suffering. We keep them if we can provide adequate COMFORT care. Like pain control, O2, nebs etc. I never alluded to it being "no big deal". I take great pride in providing a resident with the best comfort care I can, if they are in distress or palliative.