Would you wait for Dr orders?

[AcuteCare4Life]

This week has been busy at our little hospital. The heat is getting to many folks. I had just clocked out when "Cat Code" paged overhead. Stopped just a moment and thought "Hell, I better go.". Arrived to find a male pt very diaphoretic, gray and gasping like a guppy fish. First thought? Oh, they might have waited too long! Turns out the RN was a new grad/hire early in orientation. She had been trying to notify the Hospitalist of the pt's condition and when the Hospitalist called back, told new grad/hire "Stop calling me! I'm dealing with a critical pt on 3rd." The preceptor called the Cat Code. Everyone arrived and soon whisked the pt off to ICU and intubation.

Now here is where the title comes in. Would you have waited for Dr orders? Especially after the Hospitalist responded the way he did? My instinct was to swap over the NC for a non-rebreather, insert foley, give Lasix and then explain to Hospitalist what was happening to the pt. What are your thoughts?

[nrsang97, BSN, RN]

Since the patient was gray and guppy breathing it sounds like a code blue should have been called. This patient needed to be intubated. The foley can wait. Lasix seems to not be indicated at this time.

[Spidey's mom, ADN, BSN, RN]

Cat call . .. . . isn't that what some men at a construction sight do to women as they are walking down the street?

[Cola89]

Unless it refers to some sort of feline invasion I would guess it's a misunderstood way of saying cath-code.

Yes, a Cat Code is used with any out of control form of feline invasion. Thankfully, we only have to call them on a once in a blue moon at my hospital.

[Nurse Leigh]

^^ But what if a Cat Code is actually a protocol to RELEASE the cats when mice are found.

Not sure if I'm just silly today are this is the effects of not eating yet.....

[littlepeopleRNICU]

I didn't mean to like the original post, but somehow did?

OP, are you ever gonna tell us why you thought Lasix and foley right off the bat? Was there more to the story to indicate you thought the patient was in pulmonary edema?

To answer original question, no, I would've done neither of those things without an order. Lasix is not indicated. There are so many other reasons that could be affecting his respiratory status where Lasix would have no effect. You also know nothing about the man and history, other than what you see in front of you.

Assuming the "cat code" is equivalent to a rapid response, I would've just switched to a NRB( like you did) and waited for them to come and assess and use their own ability to freely implement standing orders. Giving (unordered) Lasix and placing a foley is not in your scope as a clocked out *RN*, who has no official care of this man. Even if you are a member of the cat call team, you're clocked out at that point. Sounds like a lot of liability.