Rescue 911---Staff Member Down!!

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Specializes in LTC, assisted living, med-surg, psych.

Just when I thought I had a safe, sane nursing job.........

I was eating my lunch this afternoon when one of my staff members yelled, "Marla, you'd better come have a look at (name withheld)---something's wrong with him!" Within 15 seconds here came the both of them, the one caregiver literally dragging the other, whose eyes had swollen shut and who was grabbing at his throat and gasping for breath. All he could do was whisper "throat.....tickles.......can't breathe". We got him to a chair and he continued to wheeze and cough weakly; he shook his head when I told the med aide to call 911, but no sooner had I turned my back to direct traffic away from him than he collapsed on the floor!

By this time, he was unresponsive; his pulse was thready, tachy, and slightly irregular, and his skin was cool and clammy. Sternal rub brought him around only for a brief second; I couldn't get a BP, and in the meantime the dispatcher was telling my med aide to prepare to do CPR. Bless her heart, she was scared half out of her wits, but she's had training, and she did everything correctly........fortunately, we never lost his airway or his pulse, and the EMTs got there and slammed in some epi and some Benadryl, which brought him around enough to reduce the swelling and enable him to talk. THEN he didn't want to go to the hospital!! Dang kid---I know he doesn't have health insurance, but he'd been minutes from death right there on the floor, so I told him "No way, buddy, you're GOING."

At that, he smiled, just a little, and said to the EMTs, "You heard her.....and I always listen to my nurse". That's when we all knew he'd be OK..........but what a FRIGHT!! The poor residents were almost beside themselves; they all know and even expect that someday they'll be the ones taken out that door on a stretcher, but even some of our former nurses and our ex-MD were more than a little shaken by seeing this strapping young man laid low........and by what, we still don't know. He's had asthma since he was a child, but no history of anaphylactic shock before today. WHEW!!!!!!!!!

The last I heard, they gave him a little more Benadryl and some prednisone and sent him home; he'll be fine in a day or two. I hope he got an RX for an Epi-Pen---the staff and I privately agreed among ourselves to chip in for it since he doesn't have much money---or, failing that, we can figure out what caused the anaphylaxis. Of all the situations you never expect in assisted living, I'd have to say coding a co-worker would have to rank close to the top. Thank God he'll be all right........in fact, I half-expect that kid to show up for work in the morning, even though I've given him the rest of the week off. Thank God for Benadryl and epi and EMTs. And thank God for giving this young man a second chance!:yelclap: :yeah: :w00t:

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Specializes in RN, BSN, CHDN.

OMG you are a star-thank god you were there to help save his life. You are just great

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Gee whiz! There have been a few times where good bosses have saved my butt, but this gives an entirely new meaning to the phrase. Good work, Marla.

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Specializes in LTC, assisted living, med-surg, psych.
Gee whiz! There have been a few times where good bosses have saved my butt, but this gives an entirely new meaning to the phrase. Good work, Marla.

:lol2:

Thanks, but I didn't really do anything other than direct traffic and bark orders at people.........I'm just glad I happened to be in the building at the time, because no one else who works there really knew what anaphylactic shock looks like. They do now.:uhoh21:

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Oh my! He's lucky you were there to help! I hope he get plenty of rest!!

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Specializes in NICU, Infection Control.

One of our RNs on night shift walked into the pantry--and slid on the wet floor (which DID have a sign, but you know..). Landed smack on her knee. Off to ER in a wheelchair. They d/c'd her after appropriate treatment and wheeled her back to OB. She'd driven in w/someone else and didn't want to call her husband @ 3am. So, they put her to bed w/an ice-pack til morning.

I had one of our volunteer cuddler go out one day--just slid to the floor--he wound up going to angio--had a complete blockage of one of his carotids. He was ~ 80ish. His main concern was that we wouldn't let him hold babies anymore. Eventually we did.

It's such a horrible shock to have a staff member/volunteer, etc., do something like that. Sounds like the staff performed perfectly, tho--that should make you proud. Just as soon as your Lidocaine gtt kicks in and you stop having those dratted PVCs. (just kidding) (do they still use that drug--not exactly up on my cardiac stuff.)

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How frightening! I went into anaphylactic shock myself, almost died... O2 sats in the low 70s. See, I knew I was allergic to Penicillin, but my cat had her uterus removed and was on ampicillin. I had to give it to her, and you know how that goes... put it on the back of her tongue, she spits it out, repeat, repeat, etc... well, apparently enough absorbed into my fingertip that two hours later I woke up in full anaphylactic shock, airway swelling shut. I lived across the street from a 24-hour Walgreens, and I stumbled across the road in my PJs and into the store and collapsed, the pharmacist gave me an epi-shot and saved my life, by the time the EMTs got there my O2 was in the low 70s but rising. I spent a week in the hospital, 48 hours of that in ICU. All because of giving a pill to my cat! Gave me a new respect for the power of allergies though...

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Good job, Marla:flowersfo

Thank goodness you were in the building! :yelclap:

Can only imagine what the outcome would have been otherwise - the chaos, coupled with lack of knowledge regarding anaphylaxis - don't even want to think about it.

Lori, I've gone into full-blown anaphylaxis too. To Sulfa. Now if I even have to give a Sulfa pill to a patient, I wear gloves. Would not want to go through that again.

Marla, your job sure keeps you hopping, doesn't it?

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Specializes in NICU, Infection Control.

Lori--next time, tell the vet, NO Amp!!!

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Specializes in Acute Care Psych, DNP Student.
How frightening! I went into anaphylactic shock myself, almost died... O2 sats in the low 70s. See, I knew I was allergic to Penicillin, but my cat had her uterus removed and was on ampicillin. I had to give it to her, and you know how that goes... put it on the back of her tongue, she spits it out, repeat, repeat, etc... well, apparently enough absorbed into my fingertip that two hours later I woke up in full anaphylactic shock, airway swelling shut. I lived across the street from a 24-hour Walgreens, and I stumbled across the road in my PJs and into the store and collapsed, the pharmacist gave me an epi-shot and saved my life, by the time the EMTs got there my O2 was in the low 70s but rising. I spent a week in the hospital, 48 hours of that in ICU. All because of giving a pill to my cat! Gave me a new respect for the power of allergies though...

This brings up an interesting point. The pharmacist saved your life by giving you the epishot, thank goodness. Legally he couldn't do that - now could he? I've thought about this because I carry an epipen. If I saw someone in anaphylactic shock of course I'd do the proper thing, call 911. But if they don't get there in time and the person might actually up and die - I'd give them the shot. I'm not an RN yet. What happens if one does this, RN or not? Oh the ethical quandry and quick decisions!

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This brings up an interesting point. The pharmacist saved your life by giving you the epishot, thank goodness. Legally he couldn't do that - now could he? I've thought about this because I carry an epipen. If I saw someone in anaphylactic shock of course I'd do the proper thing, call 911. But if they don't get there in time and the person might actually up and die - I'd give them the shot. I'm not an RN yet. What happens if one does this, RN or not? Oh the ethical quandry and quick decisions!

good question ... If it was really taking the EMT's that long to get there, I wonder if you could have 911 contact med control and have them give you permission to do it?

I wonder if that would fall in the good sameritan act or what ...

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Hard to comment on the legality of the pharmacist's actions without knowing the laws of the given state and the details of any other licensure or certification that the pharmacist may have held. Usually though, medical control just deals with the services provided by the on-duty medics at the given service.

That said, most agencies around here have a procedure where it is possible for an EMS crew to turn over responsibility for patient care decisions to a physician on the scene of an emergency. Of course, this is in coordination with medical control and only applies if the physician can provide evidence of a medical license (which usually they cannot). No such protocol usually exists for other healthcare providers.

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