OF mega codes and AED's in LTC...(kinda funny!)

Long Term Care Columnist / Guide · Mar 7, 2005

YES! I think all healthcare facilities, including assisted living, should have at least one AED and all staff should know how to use it. In fact, I think ALL public buildings should have them......it doesn't mean everyone has to know ACLS---that's what you call EMS for :) ---but studies have repeatedly proven that survival rates are considerably higher for cardiac arrest patients who receive early defibrillation. That alone should be reason enough for TPTB to purchase one.....and in a perfect world, they would. :)

BTW, good job on passing your ACLS!!! WOOT!!!!!

begalli · Mar 7, 2005

So, this leads me to a question... do you feel that all facilities, even LTC and Assisted livings should have AEDs? (not necessarily a code cart...but at least an AED!). We discussed this as a class at length..and we all feel that it should be there..heck, people may be DNR...but are all staff DNR???? OR family visiting???
What do you think, and should it be mandatory that all medical facilities have one???

Yes! Especially Assisted Living and LTC places for EXACTLY the reasons you stated...family visiting. Lots of CAD walking around visiting those places I'm sure!

I think AED's should also be available on floors of a hospital where they don't do a whole lot of codes. We certainly don't need one in the ICU, but other floors and areas of the hospital would benefit, I think.

Antikigirl, ASN, RN · Mar 7, 2005

THanks! I was so nervous I was unsure of myself..but I started laughing and feeling more comfortable giggling with the paramedics and RN's more skilled than I (at my expense..that seems to work for me..LOL!)..and I relaxed and only got 3 wrong on the exam! WOW!!!!!! Blew me away!!!!!

Anyway..I thought it was a great thing to learn (or in my case re-learn) because it helps me to hone in on what a paramedic or ER nurse is going to need/want to know in order to get a move on, and not waste so much time having to sort everything out in order to make a choice in meds especially! I can now think about warning someone of certain histories or current treatments I may not have considered previously to have made a difference. Saw cases that reminded me of so many 9-11 calls I have made and how I actually did make a difference by getting the info out (if I was being listened to..LOL!). And heck, at least get them into a position because I know what they may do and how that recliner is really going to hinder things..LOL!

I had fun...I think it would be great to teach it in a 'nurse friendly' way so that us nurses know what paramedics need to know for continuity of care :). Of course mine class would be more comedy and also 'what they need to know and why"...but how fun!!!! :) :) :)

And gee, go figure I think all places should have an AED especially medical! There is a great trend going on in my county where police now carry them YEAH!!!!!!! But alas, my facility has REFUSED them saying it would take too much training, to much money, and all our pts are DNR..and when I brought up the family or staff thing..they told me not to do CPR or anything on them because of liablity (yeah BS!!! I so will treat to the best of my abilities!)....They are ignorant, stubborn, money pinching, and totally WRONG. I will tell them that when I leave (hopefully soon, that home loan is almost complete!! YEAH!!!!!!!).

apaisRN, RN, CRNA · Mar 7, 2005

Something that makes me nuts is AEDs in schools. Laypeople are deciding that we MUST have one, we must keep children safe, and spend thousands of dollars that could have been well used elsewhere. Shocking a child is almost never appropriate. This makes sense to a health care professional - v-tach and v-fib are usually the end result of CAD and children don't have it yet! (although with the obesity epidemic . . .?) And then an assisted living facility doesn't have one. If all the patients are DNR that changes the scene a little, but visitors are still at risk.

Anyway, sounds like a fun ACLS day! I have a class in April.

mattsmom81 · Mar 7, 2005

ACLS is conducted as an interactive learning experience, and is MUCH better than it used to be, so nurses shouldn't ever worry about it. Its designed for everyone to learn now. :)

ACLS back in the early 80's used to be a terrifying experience and the docs and paramedics purposefully made the atmosphere punitive...they didn't think nurses should be doing this stuff.

I still remember a hotshot paramedic who had his own agenda and gave acute care nurses field megacode scenarios ...just so they could show us up.

nerdtonurse?, BSN, RN · Jul 29, 2009

In keeping with the "Code" theme....my uncle Jack told me this one....

Years ago, Uncle Jack was a Duke's ER -- he'd gone to the cardiologist, and had an episode and almost died in the office. He's in the ER getting admitted. He was feeling a lot better after being cardioverted, but they were still going to admit him. It was the beginning of the ER rotation for some interns, who were introduced to Uncle Jack, and who seemed to be absolutely jonesing for someone to do something interesting.

Two beds down is a drunk. Slurring his words, and wandered into Uncle Jack's cube twice (and he said he almost got drunk just sniffing the guy), only to be chased out by nurses. Guy keeps telling people he's not drunk, he hasn't had a THING to drink. Uhhuh buddy. We believe you.

Well, with all the back and forth, he keeps pulling the telemetry leads off, and the system keeps reading asystole, all while the drunk keeps saying, "Ah hashent ha nuthin to drink...."

Can you see where this is going?

Guy pulls off his leads and flops back on his bed just as one of the interns goes by and sees "asystole" on the monitor. Somehow he grabs the crash cart, and tears into the drunk's room yelling code blue, whips out the paddles and BLAMO, shocks the fool out of the drunk. Drunk jumps up and starts screaming, "Alright, alright, I had a case of beer, jeez!"