What do you do when a pt goes into anaphylactic shock?

[xmilkncookiesx]

I start clinicals in a few weeks. I'm in my first semester of nursing school.

I'm so scared of my pts going into anaphylactic shock.

How do you know it's happening?

What do you do?

What do you tell the staff around you during this time?

What happens if you freak out and step away? Can you do that as a student since you don't know what exactly to do yet? (We weren't taught anything except that it's an emergency crisis reaction to whatever they're allergic to)

Also, what is "code"? My professors say it a lot saying either they never had a pt who codes or they had one who codes.

What does code mean and what is it?

What do you do in the event?

Please tell me all of the codes. Please tell me what type of emergency situations can happen and what you need to do (in details and explain why).

I'd like to know to be safe than sorry and make sure my pts lives are not at risk because of my lack of knowledge and me being so scared freezing up.

[JenTheSchoolRN, BSN, RN]

I've seen a couple anaphylatic reactions (one was the scary one you just hate to witness, I cross my fingers there!), but I'm a school nurse, and they were both food allergy related. Epi-pen in hand, call 911. No rapid response on hand in a school - just me. But thanks to good allergy action plans, Epi-pens, and >10 minutes EMS response, both had good turnouts.

Oddly enough, most of my friends that work at a hospital have never dealt with an anaphylatic reaction.

OP, relax. You can't know everything on the first day of clinic. Heck, you can't know everything after working 10 years as a nurse either!

[T-Bird78]

I've spent my entire nursing career in allergy and even in that environment I've never had anaphylactic shock, just systemic reactions. As a nursing student you aren't expected to know what to do immediately. If in doubt, get help. You won't be alone with your pts for quite a while, you'll either have a classmate or preceptor with you. Check vitals if they look like they're starting to go down (provided nothing major is going on, of course) so you'll at least have a baseline.

[TU RN, DNP, CRNA]

Bowel sounds. Definitely auscultate bowel sounds with anaphylaxis. Critical intervention

[Horseshoe, BSN, RN]

20 years experience, never witnessed anaphylactic shock. I've certainly been involved in codes, but never due to anaphylaxis.

[betbrennan]

All responses are great. Good for you, being a nursing student and reading or even being aware of this blog. Don't worry, it will be ok.

[emtpbill, ASN, RN, EMT-P]

Working as a medic I've had more codes then I care to remember. Being the only one in the back of an ambulance it is all on me. Getting the patient intubated. IV or IO initiation, drug pushes, defibrillation/cardioversion.

As I am currently in nursing school I feel I may have a small advantage as that I have already experienced these things and know what to expect.

As far as administering meds, listen to the doctor. Otherwise follow ACLS.

[emtb2rn, BSN, RN, EMT-B]

I called a code during nursing school & initiated compressions. That said, i had prehospital experience so it wasn't my first time. You will do compressions maybe ventilations. You will NOT administer anything. That's outside (waaaaay outside) a student's scope of practice.

[TheCommuter, BSN, RN]

I've participated in more codes than I can count. To be honest, I prefer dealing with patients who have DNR (do not resuscitate) orders because the code blue process is brutal and grueling.

In addition, it is almost always unsuccessful on patients beyond a certain age range. However, we live in a death-denying society where people think codes are similar to what they see on TV programs.

[xoemmylouox, ASN, RN]

I have participated in several codes. Each person has their own role. So depending on what your "role" is, you might be a recording, doing compressions, assisting with the airway, pushing meds, a runner for meds, etc. I SERIOUSLY doubt your instructor will have you actively participating in a code. You might watch, but that would be about it.

[THELIVINGWORST, ASN, RN]

I have gone to help out in other people's patients codes but I've only had one code blue on my own pt. It was a 92 year old pt whose family was in denial. I drew labs and recorded and that was it. We have a code team so we don't do much if it's not compressions or recording.

[RNperdiem, RN]

Strangely, not many considering I work in ICU. Patients rarely code without warning signs. The time to intervene is when those worrisome signs that come before the code appear.

Freezing is a natural reaction for an inexperienced person. There is a reason soldiers train and drill- when the bullets start flying, they will be able to react appropriately out of training even when they are too stressed to think clearly at first.

With experience, a nurse is better able to perform in a stressful situation. In the meantime, call for help and let your rapid response team/charge nurse/code team/nursing instructor do the work while you observe.

[ED Nurse, RN]

I code people on a daily basis- we had two at the same time a few nights ago. Unless you have ACLS you are not able to administer meds in a code situation. Even if you could, you should NEVER administer a medication without knowing the how's and whys- that is why we have ACLS. I also doubt your instructor will assign you a pt that is that ill. I would focus on learning the basics right now. If a code happens on your floor, I would watch, but stay out of the way- or get in line to do compressions if a Lucas is not being utilized. A code, is just like anything else you do- it's a process that you learn with experience. As terrible as this sounds to you now, to me running a code is like starting an IV- second nature and not a big deal.