Ready for full-code residents?

You should have everything you need on the crash cart (O2 equipment, meds, etc). If you don't feel prepared for a code, and are unfamiliar with the crash cart, you might want to consider ACLS certification- especially if you will be in charge of the code. Check with your local AHA or Red Cross- they'll be who you want to talk to about that.

we have a crash cart on each nursing wing. We only initiate CPR until the paramedics arrive and they take over. If you know CPR, you should be fine. Play out the scene in your mind a few times and prepare yourself. It will happen sooner or later. Just plan, example, can you instruct a cna to call the ambulance? Is there another nurse there who can call the doctor for you? And brush up on what you will want to chart.

i will have to give you credit for making this a priority. it is always good to know what a persons code status is, especially if they dont look to good to begin with. make sure you locate your crash cart, cpr board, ambu bag, suction machine with all the connections at the beginning of each shift. find out who else feels comfortable with performing cpr. you can carry a mask. make sure someone calls 911 right away so you wont have to resucitate for too long.

i'm a new charge nurse in ltc, night shift. i wonder how ready i would be is something happened to a resident that is not a dnr. i am cpr certified, but, i don't feel this really prepares me for a real event. i should carry a list of my full-code residents in my pocket.

do you carry masks in your pocket? i would have to run down the hall to the med room to get one. a full-code could easily turn into a slow-code.

oh marla, :imbar :angryfire

what a nightmare! i assume this patient died? let's hope so.

anyway and what marla said, the crash carts in ltc are a joke. but it is vital that you do know who your dnrs and full codes are. and call 911 or whoever the facility is contracted with.

much luck to you.

leslie

Not ALL crash carts in long term care are a joke. As a nurse, I feel it is my responsibility to check the crash cart at the beginning of the shift to be sure O2 etc is on it. Let's face it. People come to LTC to stay til they die. The families say to do a "full code" Do the families really expect the person to survive it? No. They just want to feel that something was done.

Unfortunately,BHolli, most families DO expect that their loved one will be saved by CPR. I had a family member not believe me when I told her her husband had died because she was sitting in the room and didn't hear "the alarm go off". I asked her what she meant---this was LTC ---all he had was an O2 concentrator in his room...and she said "When someone dies, an alarm goes off...I saw it on ER". It was really very sad. At least the man had decided on his own that he didn't want to be coded if he died.

Hi Betty,

I feel the same way as you. I work in a very small facility, with many "full codes" and a pretty pathetic crash cart. We are expected to start CPR and call 911. I was wondering what everyone had on their crash carts? Our crash cart is not even checked every shift or everyday for that matter! I don't mind being the one to straighten it up, any suggestions???

Hi Betty,

I feel the same way as you. I work in a very small facility, with many "full codes" and a pretty pathetic crash cart. We are expected to start CPR and call 911. I was wondering what everyone had on their crash carts? Our crash cart is not even checked every shift or everyday for that matter! I don't mind being the one to straighten it up, any suggestions???

I could tell you what we keep on ours, but it might be a little different for LTC (I'm thinking you might not have an emergency trach kit on yours, for example, but I don't know...).

Yes, our cart is very basic. No meds,or trach kits. I just wanted to know what others had on the LTC carts. I am sure that some facilities are more acute than our facility. We don't have an EKG or anything.

We have a centrally located crash cart, and ambu bags at each nurses station. Our facility does not mandate that all employees be certified in CPR, nor do they offer to pay for or provide classes...so many of our cna's and nurses are not certified, although they know what to do.

Our cart has O2, suction machine, and another ambu bag, along with other usual items, but no meds. In our documentation books at each nurses station, in the very front, we have a listing of all the residents who have living wills and DNR orders in their charts. No DNR order on the chart means they are automatically considered a full code. Therefore, this is one of the main issues we discuss when residents are first admitted. We have a rehab area, and this is taken into consideration there, too....any admission in the home has this discussed fully.

As a night shift supervisor, I have labeled my cna's according to their halls. I am over 3 halls each night by myself and usually have 3 cna's working. Each hall is specific: hall 1 cna hits the phone and calls 911. Hall 2 cna goes to the documentation book and finds out if the res is a code/no code. Hall 3 cna goes with me to the residents room. When someone is found down, a "code blue" is called over the system, regardless of what time it is and all nurses available come to the area asap. Each nurses desk has 2 phones, so while one cna is calling 911, the next nurse arriving calls the resident's doc and family members. I'll have to say, we have a pretty good routine down, and we're always ready to use it. Our staff always come running when needed and get the job done to the best of their ability. Makes me feel very comfortable knowing I've got staff that are willing to help!