A Quiet Code Blue
At the beginning of the shift, we were in the middle of getting report when a nurse could be heard faintly in one of the rooms yelling for a code blue. Within seconds, the overhead speakers were announcing a code blue on our floor. I rushed into the room and put my hand on the patient's chest, her breathing was unlabored. Her pulse was good too. The nurse said that she couldn't wake her up.
I asked if we could cancel the code blue and everyone agreed that would be okay, so the code was cancelled. We wanted to cancel it because they are such a pain. Usually about 50 people will show up for a code and most of them are just lookey-loos who get in the way and then there is a ridiculous amount of paperwork that follows. Her condition wasn't so critical that we couldn't have a quiet code. A quiet code is just calling on the phone the people that you need without overhead declaring a code. It avoids a lot of hassle.
The patient had just come back from surgery, had received pain killers and we figured that she had just been overdosed. It happens frequently. I prepared a dose of the antidote and pushed it directly into her IV line. Usually the patient wakes up within seconds, but not this time. She just laid there with her eyes rolled back.
The anesthesiologist was called and asked to come immediately. The oxygen content in the patient's blood began to drop. An oxygen mask was placed on her face and the oxygen was turned all of the way up. The oxygen level continued to drop and the patient was starting to gurgle and foam at the mouth. We knew she was in big trouble at that point.
The anesthesiologist arrived and intubated her. While she was being bagged, he started making phone calls. Several doctors arrived and they began discussing what to do. It was thought most likely that she had suffered a major stroke, so she was transferred to ICU and tests were done.
Later, we checked to see how the patient was doing and she was fine. It turned out that she did have a drug overdose. I gave the amount of antidote allowed by protocol, but it just wasn't enough to counter-act the huge dose of morphine that she had received. I'm glad that it turned out that she was just another drug overdose. That we can fix.
Written by Melissa on 11:10 AM
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Melissa blogging from sunny Santa Clarita, Southern California, United States.
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6 Comments:
I'm starting to think I'd rather die than go to the hospital. If I have something simple, I could die from mishandling. If it's fatal, I could die anyway. Staying home would be cheaper and less fuss. It's not like I'm gonna live forever. I think I'm already past my shelf life. :)
You're nowhere near past your shelf life. :)
In our defense, the dose of morphine that gives pain relief is very close to the dose that puts people in comas and everyone's drug tolerance is different. We have to make our best guess what dose to give and keep narcan handy to rescue people when we guess wrong. It's not as bad as it sounds. We haven't killed that many people. :)
Speak for yourself Meilissa. When I worked in ICU we had several a week, sometimes 2 per shift, now that's a lot of paperwork! I have to say that most of them were truly ready to move on though.
I'm with Dave, i am skeered as hell about ever ending up in hospital, i reckon my only way out will be in a body bag!
Sarah, ICU is different. I don't like really sick people and will never work there with all of the codes they have. On my floor we rarely kill our patients and I can't remember any patients, off-hand, who have actually died from our overdoses.
Michelle, most people, eventually, leave the hospital in a body bag only because few people die at home. So, I guess that your statement is correct, but it probably won't happen for many years to come. :)
I guess you just get numb to it when you watch so many people die, and you are used to prepping their bodies. It is nice when the family can't make it and you can be there to hold their hands when they pass. You can just see the pain leave their body. At least you feel like you did something to help someone that day.
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