I need to share this, in hopes that another nurse has experienced this.
I work on a Tele unit where the patients are mostly stable with MI, CHF, post STEMI, etc. We do not generally have codes on our unit...we usually can tell if a patient need to be transferred to a higher acuity unit before that.
Three days ago, I was working and a code was called on a patient.The patient had had open heart CABG about 2 weeks prior and was in our hospital being treated for Heparin Induced Thrombocytopenia. I ran to help, and relieved the person doing chest compressions when I got there. When I started doing compressions, her incision site came open, which really freaked me out, but the MD running the code told me to keep going. I also felt her sternum give out while I was doing CPR. I was worried that I might hurt more than help , but we did get a heart rate back after CPR, defib, and drugs. Unfortunately, she died the next day.
I guess I was just really traumatized by the experience...I have participated in several codes, but none as traumatic to the patient as this.
I was wondering if this is typical if you have to code a patient after open heart surgery that their incisions can open, and if there is a better way to do compressions on a post surgical patient with a fresh incision?
I work on a tele floor and we have lots of post op CABG patients, I have been told by our cardiac nurse practitioner that it helps to put one hand on either side of the incision and perform cpr that way to lessen the stress on the incision. That being said I have never had to participate in a code yet. Has anyone else ever been told this?:heartbeat
This same situation happened to me in the back of my ambulance, when I worked in EMS. Had a brand new EMT with me and we were coding this elderly gentleman who had just come back from having a CABG done. In the middle of doing compressions his incision opened up, the brand new EMT stopped compressing and looked at me with eyes as wide as saucers.
I just looked at her and said, "Don't you dare stop!" She kept doing them, and I later told her, "It's just so inconvenient that they had to put their incision right where you'd be doing CPR...how rude of them..." She laughed at that, but something we never forgot.
As for placing your hands on either side of the incision, I'm not sure this would actually work to lessen the stress on the incision since then you'd be pushing from both sides. My advice...just do compressions the way you were taught in your CPR class. If the incision opens it opens...
spunkykelly
1 Post
I work on a tele floor and we have lots of post op CABG patients, I have been told by our cardiac nurse practitioner that it helps to put one hand on either side of the incision and perform cpr that way to lessen the stress on the incision. That being said I have never had to participate in a code yet. Has anyone else ever been told this?:heartbeat