Code Rapid Response
Rapid Response to the fourth Floor.
Today was an interesting day in clinicals. It was so boring that me, being a student was able to treat all my patients within an hour. The rest of the day I had NOTHING to do. It was so slow that all the RTs just kicked back in the department. In the middle of the day I heard the page over head and people’s pagers ringing “Rapid Response”. WOW! my first Code Blue and I was running up the stairs…4 floors up with a RT. I walked in the room and first thing came to my mind “AMBUBAG!!” I needed a resuscitation bag. You know, the bag that EMTs use in the field for a patient who is not breathing. The RT was already ahead of me and threw me the bag. I opened it and guess what I see?
AMBU BAG WITH NO MASK!!!
I was pissed off and so was everyone else around the patient. I went to the next patients bed to jack one of the masks (i made sure i put another in after the code) The patient was at 2lpm and stopped breathing. Well not completely but the Sat was <70. Pulse was at 60. I didn’t put the mask on but I just did a “blow by” which was just giving oxygen from the ambubag and not sealing it in the patients face. Few mins later vitals were going up and the patient is coming up. I attached a non-rebreather and set it to 15lpm , yes you can also put it on flush. The RT got a ABG as requested by the physician. At first I remembered what my instructors said.
“When you are going to a Code, do not panic and do not try to rush because in the end you will make mistakes”.
Everyone was so calm. It was like they were having picnic under a hot summer day. I can understand that because once all hell breaks loose no one will concentrate. My first code and it was interesting.
To make my day even more interesting there was another patient who had another code. WOW 2 codes in one day and I have had NO CODES for 2 months of my clinical and today was the day. This code was kind of awkward.
We had 3 RTs including me rush into the door. There was like 5 nurses and a physician. Once we walked in, I was handed a bag and this time it had a mask. ALL the nurses walked out. (dont worry i respect “good” nurses as much as I respect “good” RTs. ) WOW…. The physician asked all the RTs what the patients Hx, and what happened and all the information. Well for your information we are “Respiratory Therapist” and dont know anything else about the patient except its pulmonary status. One RN walked back in with a bunch of medications or whatever it was. Make a long story short we did the same thing. Bag > non rebreather. WHEW.. both patients lived.
As a respiratory therapist first thing is first, AIRWAY!
Make sure you have an AMBUBAG with a MASK, non rebreather handy, pulse ox, and your BEST assessment skills.
April 10th, 2008 at 8:46 pm
Glad to hear you had an exciting day. Kind of ironic to get excited at someone elses expense, but that’s life in the medical field. We have RT students here at Shoreline, and we really enjoy working with them. I suppose it’s a chance for us to share our knowledge and experiences.
April 30th, 2008 at 12:00 am
I enjoyed your take on it. I remember as a student getting sort of jacked up during my first codes and now, a few years later, I find myself settling into that calm you described and just going through the list of what needs to be done. One of my biggest fears in RT school was that I’d freak out and not remember anything but like your teachers said, it’s just about relaxing and going through all the things that need to be done. Just last night I had a patient trying to crash and I walked by the nurse’s station on the way to get a Bipap and told her what I was going to do. When I got back, she and the PCA were teasing me about “Geez, you’re always so calm! We’re freaking out and you’re just taking care of the problem!” It was the best compliment ever!
There’s a book called The House of God that talks about “In the event of a code, take your own pulse first.”
You did great! Boy, don’t you hate that WTF(?) moment when you opened the bag and the mask wasn’t there?! Yikes!