:bluecry1:So last night I had the WORST experience that I've had since I started working in hospitals 8 years ago, and I just need to get it out to people that will understand.
Last night a nurse called out for help as she had just pulled a central line from the pt's IJ and he went asystolic. So we called the code and everyone went into action. When I walked in she was trying to hold pressure on his neck with one hand and do compressions with the other hand so I got ready to do compressions. When she stopped I checked a pulse-still asystole on the monitor and no pulse. So I start doing compressions-first compression I feel one rib break, and on the second I feel two more ribs break and (here's the worst part) the patient makes eye contact with me and hollers out "OW!" It scared the living day lights out of me, but when I stopped compressions (reflexively) he was without a pulse again and started to loose consciousness.
So I ended up doing about a minute and a half of chest compressions on a guy who was awake (when I would stop he would go out, then I'd start and he would wake back up)! It was absolutely the worst thing I have ever done to someone, and I truly can't imagine anything worse. I felt like crying I felt so bad. I know it was to save his life, but still.....I just can't get over how horrible it was to have him watching me, in pain, while I broke more ribs.
And of course to top it off he was one of the sweetest patients we've had on our floor in a long time. (After he woke up he was thanking us for doing our job when I was asking if he was having pain.) And I thought us shocking someone while he was awake enough to feel was bad....but this totally topped that experience!
Sorry to share such a downer story, but this is somewhat therapeutic for me and I'm not sure anyone else will understand this besides fellow nurses....
Specializes in Community Health, Med-Surg, Home Health.
Did the patient live? I know it was devastating to experience this, but they do mention in CPR classes that this can happen. It doesn't make us feel any better, but, you did all that you were trained to do to help this person. :icon_hug:
Thank you all so much for the positive support! I think that is just what I needed. The guy did live, and amazingly went home today! I've broken ribs before, just not on someone that was able to tell me ow-something about them telling me it hurts just doesn't sit right with me. But yes, you are all right that in the end he lived, and that is ultimately the most important part. Thank you again so much for all of your kind words!
Great job on such a great save! I once saw a documentary where the same thing happened to an ER physician. He said he was use to being caught between life and death, but not consciousness and death. In his case, CPR and nothing else they did was starting the patient's heart again and the elderly man had chronic heart disease with a poor prognosis, so he told the patient (who was awake like yours), "We have to let you go now." The patient nodded OK and they stopped CPR. I always remembered that story and now I will remember yours since it had a GOOD outcome.
I have had people revive during the middle of CPR also. It is disconcerting to say the least. They give you this suprised accusing look. Good luck and God bless you good work.
When I was working as a paramedic we came to an eye doctor's office for a lady who went unconscious after receiving IV medication. She was in cardiac arrest (PEA/Rapid A-fib) from a hypotensive reaction so we had to start CPR on her and intubate her while we gave her fluids. I'm sure I broke one of her ribs while doing CPR and after about 1 liter of fluid she had a BP and was awake and breathing but now the poor woman had a tube in her throat and at least 1 broken rib. Not what you'd expect during a visit to the eye doctor. Fortunately, most people forgive you when you save their life. Good job!
I've broken my share of ribs during CPR and it's an awful feeling. I work with an elderly population and just think about cracking these elderly dear's ribs....arrrgggh.
OMG, how awful & great at the same time that he said, "Ow". Awful for you because you know he felt pain, but good for him that he was revived . And, they always re-iterate do not worry about cracking ribs, as they will heal. You saved his life!
while working a case in the cath lab, my (unbelievably hairy) patient went in to VF after an RCA injection. back then we had these old school defibrillators and for some reason the hospital opted to go with these orange electroconductive pads (not defib pads) instead of the goop. these pads looked a lot like the american cheese slices, anyway, they were just as difficult to open. back to my story, guy goes into VF, i get the paddles and the pads, i try to open the pads, the package opens weird, making it nearly impossible to open while holding the paddles. so i ditch the pads and shock the patient with the paddles without the pads. good news is that the pt's in sinus, bad news is that the shock produces a puff of smoke and 1st degree burns... not to mention the smell of singed hair that lasted the whole day.
Specializes in ER, ICU, Infusion, peds, informatics.
it sounds like he got an air embolism after d/c of ij line,was he sitting up? pt's who are sitting up,dehydrated or breathing deeply have more of a chance of getting an air embolus when a central line is d/c'd. it's best to lay someone as flat as they'll tolerate and have them hold their breath as the line is pulled.
when i first read her post, it sounded to me like he vagaled while the nurse was holding pressure on the jugular.
while i've never had someone wake up while i was personally doing chest compressions, i was reviewing a code that one of my coworkers responded to, and this particular patient woke up -- completely -- during chest compressions and started yelling at them. unlike your patient, op, this patient is quite disagreeable on a good day.
It scared the living day lights out of me, but when I stopped compressions (reflexively) he was without a pulse again and started to loose consciousness. 
:up:
pagandeva2000, LPN
7,984 Posts
Did the patient live? I know it was devastating to experience this, but they do mention in CPR classes that this can happen. It doesn't make us feel any better, but, you did all that you were trained to do to help this person. :icon_hug: