Nursing Home Emergencies- what would you do?

[anonymous1919, LPN]

One of the scariest things I've seen as a CNA is an emergency occur with a resident and the nurse looking dumbfounded and lost. I am going to be an LPN in a few short weeks and plan to work in a Nursing Home (preferably on an Alzheimers unit, I

If a patient is having trouble breathing, not breathing (and it's unrelated to choking- where obviously you would preform the heimlich and reasses from there), having what appears to be a MI, is unresponsive.. what do you do?

I know first I would check for a pulse/preform CPR if needed, and call for the house manager/unit manager or whom ever is looking over the nursing home at the time... but then what? Should I wait for him/her to show or should I be dialing 911? I have seen emergencies like this happen and the nurses on the unit become frantic and just don't know what to do and I believe if they had a clue before this rare situation occured that residents would have better outcomes.

[CoffeemateCNA]

At my facility we call 911 before unit manager arrives.

EMS needs to get there ASAP and there is no time to lose.

Better for them to show up and not be needed rather than us not call them and the resident goes south and dies.

In the case of an MI - time is heart muscle.

[CoffeemateCNA]

Biggest part of responding effectively to emergencies is being prepared. Know what to do before something happens.

At a former facility, before every shift we would assign everyone a task in case of code -- who calls 911, who gets the CPR backboard, who grabs our little makeshift crash cart, etc.

[anonymous1919, LPN]

Biggest part of responding effectively to emergencies is being prepared. Know what to do before something happens.

At a former facility, before every shift we would assign everyone a task in case of code -- who calls 911, who gets the CPR backboard, who grabs our little makeshift crash cart, etc.

I really like the idea of assiging people a task in case of a code.:up:

[leslie :-D]

[

you always call 911 before notifying anyone else.

and yes, even if they are a dnr.

leslie

[Lorien_LPN]

Biggest part of responding effectively to emergencies is being prepared. Know what to do before something happens.

At a former facility, before every shift we would assign everyone a task in case of code -- who calls 911, who gets the CPR backboard, who grabs our little makeshift crash cart, etc.

Thats a really good idea!

[aCRNAhopeful]

I've also seen nurses at a nursing home where I used to work become frantic and not know what to do. When you work in an area that may not have emergencies very often, one just has to be mentally prepared for when they do. If the facility is not going to be proactive about it (like by making prearranged code assignments, a very good idea btw) then the nurses need to take it on themselves to be prepared. I saw so many emergencies where people can't breath well and someone will put O2 on at 2L nasal cannula regardless of what their sats are. Or a case where a BAD COPDer couldnt quit smoking cigarrettes and became CO2 narc'd and was barely breathing. There was an ambu bag and masks in the building but he got the 2L nasal cannula special until EMS came. So my point is, just be prepared ahead of time and you will do great and be able to remain calm. And remember the first thing on the BLS algorithm is to call for HELP. You can start treating the patient while the next person on scene calls EMS.

[proudtobeRN777]

i would say , call 911 and then start your interventions ...

[Nurse Joey]

If you're going to be a LPN in a few short weeks shouldn't you have a good working knowledge of BLS? The basics, establish that this patient is unresponsive, and not just sleeping. At this point designate someone to call 911 and someone to get you an AED, if you are trained in its use. Do your ABC's, and pick your interventions from there, clear airway, support breathing, chest compressions... etc.

[anonymous1919, LPN]

If you're going to be a LPN in a few short weeks shouldn't you have a good working knowledge of BLS? The basics, establish that this patient is unresponsive, and not just sleeping. At this point designate someone to call 911 and someone to get you an AED, if you are trained in its use. Do your ABC's, and pick your interventions from there, clear airway, support breathing, chest compressions... etc.

Of course, I understand that if the patient is not breathing I am obviously going to start CPR. I said that in my original post. I am asking when it is appropriate for me to dial 911. To this, I am unsure of since I have never been in that sort of situation. I am asking for your opinion of this so that when this situation occurs I can make the right decision instead of being one of those nurses who is lost.

*I am not asking if I should dial 911 before or after I start CPR. I am asking WHEN is it appropriate for ME to have the call placed. Before the Unit Manager arrives or after.

[Bug Out, BSN]

Call 911 first!

I don't even call the Unit Manager or DON until after the pt has arrived at the hospital and the POA/family notified.

Damn the paperwork and bureaucracy, lives are on the line!

P.S. I have been known to fax charts/paperwork to the ED while the pt was in transit when time was tight.

[Nascar nurse, ASN, RN]

Check code status... we do not call 911 if they are a DNR.

Once code status has been established call 911 immediately - do not wait on supervisor or anyone else. If you can not figure out code status quickly then assume full code and call 911.