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

Published

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...

Specializes in NICU.

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?

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.
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.

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
Specializes in Emergency/Cath Lab.

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.

Up Vote Up Vote ×

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?

Up Vote Up Vote ×
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

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.
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.

See it would have been cool if we could have participated more but we were specifically told to be a "fly on the wall" and only help for things like if they need something from supply room. We have a very big response team to all staff assists calls and codes and as students that wasn't the time for us to be "taught" and for sure not get in the way. We were highly encouraged though to watch and do anything "simple". Maybe because we are new to hospital clinicals.

I got to be in the ED last night and stand in on a trauma, that was pretty cool too.

Up Vote Up Vote ×
Specializes in Critical Care & ENT.

Just like how everyone is saying...do this...do that....you will not find a perfect roadmap on what to do in every situation. One of the most important nursing skills--->Assessment. It's also good to validate what you find. If your a nursing student you may not have had enough experience on how to be confident with what you find.

I had this same situation happen to me as a RN...been practicing for about 2 months...and I hit the code button right away. (It causes no harm to have everybody go back to what they were doing if I was not correct and the patient was okay.....if I was right and didnt call right away..hmmm) The objective is to get help ASAP. The patient was not breathing and unresponsive so we started CPR right away....he lived!

The American Heart Assoication has the BLS for HealthCare Provider. Take that CPR course ASAP. If your in school and your doing clinicals and you hear a code being called, ask your instructor if you can go watch.

Up Vote Up Vote ×
Specializes in School Nursing.

Just to add to what others have said about the ABCs, most beds have a pedal that allows them to be quickly laid flat for a code situation...learn how to use it. Also learn where the CPR boards are and how to access them. Most rooms will have emergency equipment at the bedside also, ask your instructor to go over all that in an empty room one day.

If you are the one to hit the code button, you can help tremendously in those 15 seconds before help arrives just by laying the pt flat and getting the CPR board out (even if you need help to roll the pt to use it), and getting ready to bag them.

You would/should never give mouth-to-mouth in the hospital. Or outside of the hospital for that matter unless you have proper protective equipment.

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.
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's the story. :|

Up Vote Up Vote ×
+ Join the Discussion