Tuesday, September 25, 2012

Code Blue, ER Waiting Room

Dude, I'm waiting for the day. Hopefully I'll be gone by the time we have to start CPR in the waiting room.  But we've had a couple false alarms in the mean time.
How about the drunk girl whose mom decided she was dead? Yeah, as opposed to calling 911, mom sure did scoop her early 20 something daughter up and throw her in the car when she became unresponsive.  She, um, monitored (?) her on the way to the ER, during which time her pulse became "weak" multiple times.  Mom then initiated compressions, until daughter woke up.  When she would drift off, mom would initiate compressions again.  Repeat the steps above until they reached the ER, when mom ran frantically into the waiting room screaming that they were doing CPR in the car. Poor newer nurse at the desk that night believed her, paged it overhead, stretchers were rolled out to the car until everyone got out there and... yeah.  Dr. Muscles, who is already high strung anyway, had a total shit fit when the girl got back to the room and the staff cancelled the code blue and activated code drunk.  Okay, great, how about a couple saline boluses.. hello.. ah, nope, you're already walking away.  Luckily I was charge, Dr. Muscles likes me, and the situation was diffused.  Well, up until ER BFF accidentally let on her feelings about the situation while giving report to the oncoming nurse.  It went something like... "Yeah, so they were having trouble waking her up at home, and then momm initiated comppressions? And...yeah" (add WTF shrug and wide eyes into the mix) when mom chimed in "I SURE DID!"  Yup, I guess she still probably thinks she saved her daughter's life, as opposed to doing a modified sternal rub.  MMKay, thanks for choosing Hood Hospital.
Then the other day, some girl fakes a syncopal episode at the triage desk. Yeah, it happens about once a week anyway, but this time some random patient runs up to catch her whilst yelling "CODE BLUE! CODE BLUE!", eliciting blank stares from the staff.  Another patient chimes in. "C'mon you guys, code blue!"  Everyone quieted down considerably when the ammonia caps were deployed.  Guys.  You have GOT to stop watching Grey's Anatomy. 
I think the foolishness people pull in the ER is so foreign to the average person that they assume anyone who falls down has actually passed out.  Very rarely does this ever actually happen.  Someone decided to play this game the other day.  She did a terrible job, but since she was twice my size, I just had to wait for the charge nurse to run out with the ammonia caps to expose the truth.  In the mean time, some sweet, unsuspecting big dude came over to render aid.  Poor guy, he was so concerned.  "Oh man, she must have finally passed out from the pain", he said.  "Yeah.  She's fine. People are coming, but thank you", I told him.  Yes, she looked like quite the fool whenever she immediately sat up while trying to bat the ammonia cap away.  I saw the same gentleman on the way out and thanked him again for helping.  He asked me if she was alright.  My triage partner chimed right in.  "Yup", he said.  "That happens sometimes when we have long waits."  The nice man was shocked.  "Seriously? WOW."  He walked away shaking his head.
Yeah. With the way it's going here, it'll happen one day.  But we'll be terribly skeptical when it does. 

7 comments:

  1. "CODE BLUE CODE BLUE!" I nearly died laughing. And drunk girl was lucky hero-mom didn't hurt her unnecessarily ... if you don't know when CPR is needed, how skilled are you in doing it? Yeesh.

    A few years ago I was at a restaurant and swallowed my soda (yes, soda ... not food ... a liquid that cannot obstruct airways) funny and started coughing. Like, EPIC coughing - make the whole restaurant stare at me coughing. I am making dismissive hand gestures trying to let people who seemed concerned know that I am not dying, except perhaps of embarrassment. My high strung hypochondriac drama addict (now ex)husband stood up so fast that his chair flew across the floor and at the top of his lungs yelled "DO YOU NEED THE HEIMLICH MANEUVER?!?!?!" He meant well, but now I am coughing even harder because my body is trying to both laugh hysterically and cough. I later explained that if I was coughing I wasn't choking but he didn't believe me ... proven years later when he demands to be taken to the ER for trouble breathing and when the poor ER nurse is asking him questions he screams at top volume "I can't breathe! I can't get air at all!" The nurse looked at me, I looked back with pleading eyes ... I think she was the first person who believed me that he was diagnosable crazy, not actually sick. :(

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  2. Awesome post! I read your blog religiously. Any advice for a new nurse? I'm in week 3 of an ED internship program and I feel like a complete retard-o. Also I'm pretty sure the nurses I work with fly home on pitch forks. Does anyone remember bein a new nurse? Any advice?

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    1. Unfortunately, I remember far too well. It isn't easy, and its totally okay for you to still feel dumb, it means you're humble and realistic. It just takes time mostly, but I found making lists of what I had to do and taking a sec to prioritize helped a lot. Life threatening and potentially life threatening first. Not much else is worth sweating.
      as for assholes - not much you can do but keeping honest and professional and working hard. And watching your back and waiting a long time to see who's trustworthy. It gets easier, I promise. Feel free to email me if you have anymore questions or if you just need to vent.

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  3. One of my favorite things to do in life is break open an ammonia cap under a DramaCodeBluer's nose. I feel like Jesus bringing them back to life. Well, not really, but it's still satisfying. Which says something about me and the general state of society, I'm sure.

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  4. What's procedure for a REAL syncopal episode? Like, say someone has a condition (such as neurocardiogenic syncope) in which their heart briefly goes into asystole and bp tanks but then less than a minute later comes to? No time for amonia or really any need for that or CPR as they eventually come around before help even gets there. Leave them alone? What?

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    1. Hope they are wearing a helmet.

      We all are asystolic between beats...

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