What to do when a patient codes

[TX3837, LVN]

I'm a new nurse, I work in LTC/Rehab. I've only been working for a couple of months but other shifts have had patients code. This is probably a dumb question, but I feel like I wouldn't really know what to do if a patient coded. I'm scared that I won't know what to do, any words of advice? I really want to know what to do if an emergency arises.

[roser13, ASN, RN]

Are you CPR-certified?

Do you have a code button on the unit?

Did orientation to your facility include code instructions?

[Emergent, RN]

Call for help and begin CPR

[emtb2rn, BSN, RN, EMT-B]

Know the code status of each resident as well.

[bgxyrnf, MSN, RN]

It's really super simple:

Know the code status of each resident as well.

Call for help and begin CPR

Nothing more to it than that...

[bgxyrnf, MSN, RN]

The preceding assumes that you're the person who encounters the pulseless resident.

There are other things that need to happen, too:

1) Make sure somebody calls 911

2) Make sure somebody is getting an AED

3) Make sure somebody is writing down what's happening... the ED docs will want to know (a) how long was the patient down before CPR, (b) when did the patient arrest, © how many shocks were delivered before EMS showed up and took over, and (d) has the family been notified and/or what is their contact number.

4) Make sure somebody has the POLST form for the medics and ideally a copy of the PMH and med list.

What little chance the resident has to survive, let alone survive intact (presuming that they were to begin with), depends on: (a) how quickly good CPR is initiated, (b) how quickly they are defibrillated, and © how quickly they reach definitive care in the ED... anything that helps reduce those three times is helpful... anything that delays those steps is harmful.

One other thing: It is ideal to have somebody watching the CPR to give feedback to the compressor... remember, at least 100 per minute, full recoil of the chest, and at least 2 inches deep... and change compressors every two minutes... even young, strong, athletic men start to suffer in the quality of their compressions after 2-3 minutes... it is super hard work.

If available, it's helpful to have suction ready and somebody set to use it.

It's also helpful to have a step stool available for the compressor to stand on as well as a hard board to put under the chest to facilitate effective compressions.