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You walk into a pt room & they are not breathing, whats the 1st thing...

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Whats the 1st thing you do AFTER hitting the code blue button? Step by step someone please lay it out. Its one of my biggest fears...

Initiate CPR - which starts by you trying to see if you can shake them awake.

So, I do a sternal rub, then what? Should I put the bed flat and begin chest compressions? I don't think...or want...to do mouth to mouth...

But after the code blue alarm sounds, it should be seconds before people begin to run into the room....so is chest compressions the only thing needed?

KeeperMom

Specializes in ED. Has 10 years experience.

Every facility is different but I would advise you to look at your assigned patient's chart right when you come onto the floor to see if he/she is DNR.

As a student, all you are really qualified to do is place to patient's bed flat, and place the CPR board underneath if you can. Many hospital beds are now equipped with a headboard that pulls off to become a back board.

Most likely, by the time you do that much the code team is in the room and you just need to step aside. If not, you are supposed to initiate BLS.

meredith

Yeah you definitely should find out the pt's code status before you do anything at all.. thats one of the first things we always know. Depending on where you're clinicals are, a DNR isn't necessarily as frequent as it would be in a nursing home or something. If the pt. is a DNR we were instructed to just call the nurse and stay with the pt, don't leave their side and just be there for support.

ABC - Airway, breathing, circulation

- Check their airway to see if it's obstructed, if so remove the obstruction

- Assess their breathing, if no respirations, initiate rescue breathing... be sure to open the airway by tilting the head back and only blow in for 2 seconds, 2 times in 30 sec intervals (Double check that information though)

- Assess their pulse/circulation... if none, begin full CPR... 30 compressions, 2-inches deep then 2 rescue breaths

whats the 1st thing you do after hitting the code blue button? Step by step someone please lay it out. Its one of my biggest fears...

i need some help in here!!!!!!!!

whodatnurse

Specializes in Psych.

i need some help in here!!!!!!!!

Yeah...don't forget you're not ALONE there! ;)

Check your scene out. Shake their arm and ask, " Mr./Mrs. so and so are you ok?!" Call code blue. Then start on your ABC's.... Check airway, then check their breathing, then circulation. Look, listen, and feel is another way to remember it. Look to see if chest rising, listen for any breaths, and feel for a pulse. Depending on what's going on with the patient you'll go from their to do cpr, defib, etc.... hope this helps.

Edited by >--stethoscope--o
spelling

MC1906

Specializes in Critical Care & ENT. Has 10 years experience.

It is hard to memorize what to do in every situation step one, two, three, etc. As a nurse you will see that you are doing several steps all at once. However, you do follow the basics of BLS/CPR. You may want to make sure you know where the code button is located and what is the hospital policy on how to initiate a code. The patient may also be in respiratory distress and may require similiar interventions. During nursing school you may also want to consider working as a nurses aid/assistance to allow you to feel more comfortable in the hospital environment. The best "code" to watch is the one that is not your patient and you have nothing to do but watch.

anticoagulationurse

Has 7 years experience.

A - Airway (is there something stuck?)

B- Breathing - You already checked this, which is how you know they're not breahting

C - Circulation, check their pulse.

You obviously wouldn't start CPR if they have a pulse.

~Mi Vida Loca~RN, ASN, RN

Specializes in Emergency Dept. Trauma. Pediatrics. Has 6 years experience.

You hit the staff assist or code button in our hospital and you will have about 20 extremely experienced people in the room within 15 seconds.

First thing we are taught is check their code state, if DNR do nothing and go let the nurse know. (do nothing if you see they are not breathing) if they looked like they were struggling to breath then we would do something like give Oxygen, sit them up and stuff.

Oh and before calling codes, make sure you have assessed that something is wrong, not that patient was sleeping and it looked like he wasn't breathing when he was or something.

Guess that happened before, code team and everyone came running it and freaked the poor patient out who was in a deep sleep and perfectly fine :|

Edited by ~Mi Vida Loca~RN

HyperSaurus, RN, BSN

Specializes in NICU. Has 9 years experience.

This is an interesting thread. This is something that I've started to worry about--what do I do if I see a pt pulseless or not breathing?

~Mi Vida Loca~RN, ASN, RN

Specializes in Emergency Dept. Trauma. Pediatrics. Has 6 years experience.

This is an interesting thread. This is something that I've started to worry about--what do I do if I see a pt pulseless or not breathing?

I think it's a pretty common worry, our first pre conference for hospital clinicals one student asked and just about everyone look relieved someone asked LOL. Our instructor was like, make sure they really aren't ok and hit the code button and be a fly on the wall and watch the process. She was like, don't go run and hide in a corner for the next few hours. Guess another student freaked out before and got scares and went and hid but forgot to hit code first :|

If you pull a code and your hospital is anything like mine (where you will have like 15 people in the room with machines and stuff in less then a minute, you can do stuff like move the tray table out of the way, walkers, chairs shove them all in the bathroom or something but try and help clear the room for everyone. That is what me and my friend did for one code.

She was like, don't go run and hide in a corner for the next few hours. Guess another student freaked out before and got scares and went and hid but forgot to hit code first :|

OMG, they just left the room and hid!?

I am pretty scared about haivng to call a code as well. I have been on the hospital floor for only 2 clinicals, and I got home and realized that I don't even know what button to press if my patient codes. Nobody went over that with us, and I was too busy assessing and doing things for my patient to observe where the actual button is. First thing I do today will be to go in my patient's room and scope out the code blue button.

That Guy, BSN, RN, EMT-B

Specializes in Emergency/Cath Lab. Has 6 years experience.

Call someone like me into the room to start the thumping :) Seriously though like others have said, know the code status and do your ABC's. While if you pull the code button tons of people get running into the room, I HIGHLY recommend you participate in as much as you possibly can. It is a truly amazing experience and once you do it the first time, you are that much more comfortable the next time it happens.

i know that you need to know your patient before you get in the room - however, before i began properly working with a patient (this is our first clinical rounds in a long term facility), i was briefly introduced to him. at that time, i hadn't looked at a chart/mar yet and had no idea if he was a dnr client (in hindsight he's not). i did have the instructor with me, who seemed very aware of his status. but if, hypothetically, i was sent in alone just to introduce myself and found my patient in the condition being discussed in this thread and did not know his dnr status, would it be irresponsible not to attempt some cpr until someone on the code team came and notified me not to resuscitate?

according to what i know so far (yes, we're merely halfway through our first semester:o), rescusitating someone with a dnr order constitutes battery. would i be held liable in that situation?

A - Airway (is there something stuck?)

B- Breathing - You already checked this, which is how you know they're not breahting

C - Circulation, check their pulse.

You obviously wouldn't start CPR if they have a pulse.

Well, not entirely true....they need to have an adequate pulse. Meaning, if their pulse is like 10 or 20 bpm, you'd most likely still start CPR. The same for once you defib someone, if they do happen to regain a pulse from the defib, you still continue CPR for 2 minutes, you don't just stop cuz they have a pulse....but this is all semantics.

But, here's my thoughts on finding that person not breathing:

1.) Ensure they are not breathing (try to arouse them, etc.)

2) Call for help (yell into the hall, hit the code blue, etc) --> Whoever comes should come with the defib, monitor, etc.

3) Use an Ambu bag to give 2 breaths

4) Check for a pulse

5) If no pulse, Begin compressions

I am pretty sure that even as a student nurse, it is still our duty to do CPR...We are all BLS certified. I personally performed CPR as a student, but never had to initiate it, but I was able to do it when the situation arose.

Jeff

Edited by Silverdragon102
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