Telemetry Code

[poohbear1968]

This past week while in clinical there was a code on the floor. It was amazing how nurses, doc's, etc were coming out of the woodwork to assist. Unfortunately there were way too many people in the room and I was unable to see anything. I just tried to stay out of the way. Later that day I was thinking about what I would do as a nurse who came into a patients room who was breathless and pulseless. Can someone explain to me what happens next. What are all the facets of the nurses role.

Thanks!

[UM Review RN, ASN, RN]

Your hospital probably has a policy for Codes somewhere. Ask your educator or your charge nurse to get a copy of it and study it. Our hospital's policy might differ from yours and you are legally bound to know that policy. An ACLS class helps too.

That said, you probably won't see a lot of Codes. But you will see a lot of patients in respiratory distress and have to call a Rapid Response. Your first response in that case should be to Oxygenate. Even a CO2 retainer can have oxygen in an emergency for the few minutes it'd take for the Repiratory Therapist to get to the room.

If a patient is breathless and pulseless, hit the Code button and/or go out into the hall and yell, "I need help in here NOW!" if you suddenly cannot find the Code button. Even if you can hit the Code button, hit the call light too. If you have a cell phone, call the desk to confirm the Code and get things moving. You want help and you want it now.

Make sure the patient's airway is open. If the patient is already on O2, crank up the O2, because when the crash cart and Respiratory gets there, they'll most likely begin bagging to oxygenate the patient.

The backs of our beds come apart to make a backboard for the patient, so roll the patient, get the back board under the patient.

Find your CPR markers and begin good, hard, fast compressions -- remember, the new ACLS guidelines say that good compressions are the most important factor in resuscitation. If you hear ribs crunching, keep going. I've never yet had a patient resuscitated who complained about being hurt during a Code.

By then people should be in the room or on the intercom and you can direct them to get the Crash cart and start breaths on the patient.