CODE BLITZ!!!
Holy Mother of GOD last night was busy! For those who haven't realized, I work in an ER, so...
So, I have this thing with fire trucks. Every time I see one at my hospital, it's like a raven sitting on the top of the ambulance bay croaking, "Nevermore!" They're bad omens. Every time one has been there, we've gotten screwed...sideways...with no lube. Anyway, there was a fire truck in the bay last night when I got to work. I should have stopped there. I walked into the ER and see people running like mad to our cardiac / trauma room...should have stopped there. The charge nurse looked over at me and in her sweetest voice said, "Maaaat? Can you do me a huge favor?" The pleading look in her eyes should have been my last warning.
At the exact moment I walked in the ER, we had a cardiac arrest, an active MI (heart attack), a spontaneous pneumothorax being chest-tubed by the surgeon, and every room full. The titanic is foundering. Add 15+ people in the waiting room... Sinking... So I start in trying to get report from the person I'm relieving as they guy in the cardiac room (15) starts heading downhill...pulse of 35...30...25...20...20....0. Oh shit. Titanic's tail is in the air! And...the radio goes off with 2 more sick ambulances coming in...Titanic...Sunk. F**k.
We have this code in the hospital, called a Code Blitz. It was introduced about 6-8 months ago as a quick way to deal with surge capacity. Basically, you call it, and everyone who can possibly come from anywhere in the hospital comes and helps out. Problem is, it was introduced and then forgotten about. But we remembered it. Aha! A lifeboat! I pick up the phone and call "CODE BLITZ ER STAT!" About 20 seconds later, the phones start ringing. "What's a code blitz?" After I got it explained to everyone that called, the operator, who misheard it, called a code red (fire) in the ER. Then she called a code blue (cardiac arrest), which is closer, in the ER. So as far as any visitor knew, the ER was having a really, really ,really bad day. At least it cleared the waiting room a little, as some of our frequent flyers decided that the wait just became too damn long.
We had a great response, though. We got 5 extra nurses and 4 extra CNA's, 2 housekeepers, one engineer, and another fire truck. So by the end of the next 30 minutes, we had a total of 15 nurses, 6 CNA's 3 techs, 2 EMT-B's, 1 EMT-I, 2 EMT-P's, 2 housekeepers, one engineer and 4 firefighters, all of whom we put to work.
Just after I call the code blitz, I hear "GET A RECORDER IN HERE!" so I pick up my pad and paper and run in to see another of our poor techs doing chest compressions on this 400+ pound guy. He's been going for about 2 minutes, and he's starting to flag. So I hand off my notepad to a nurse, put on a pair of gloves and take over. We switch off every minute or so while everything else goes on around us. At one point the doc couldn't see to intubate so she told the nurse to raise the bed.
Now, when you're doing CPR, your mind rather goes blank. All that matters is compressions. There is nothing else...no noise, no speaking, no thought, just counting and pushing. The person you're doing it to even really ceases to be human. I know that sounds horrible, but that's the way it works for most people. All of a sudden, he's going up...up....up, until I'm doing compressions with my arms straight out in front of me, using only my triceps. I've got good triceps, but damn. And all I can think is God damn it, now I look like I'm doing CPR in a bad medical drama!
The only think I can think of is to get up on the bed. So I get the other tech to spot me, just as another CNA walks in the door. Great! More relief! Quickly, I climb on top of the bed, wedge one foot under each side of the guy's belly and start going to town. I seem to remember one of the RT's (Respiratory Therapist) saying "That's so ER!" Finally, I'm starting to wear out, and I start to come back to reality to tell Chris (the other tech) that I have to bail. He climbs up behind me... (I should insert here that I had my knees almost locked and I'm bent at the waist to deliver compressions, which has the odd isometric effect of thrusting my hips out a little behind with each compression)...as close as he can get so when I bail, he's right there. At this point I'm thinking..."All I need right now is for the family or the local paper to show up and see this" since, according to my imagination, and apparently to the other Unit clerk watching the CCTV monitor, it must look like me and this other tech are having a little too much fun on top of this dead guy.
ME: All right, Chris, I'm going to count down, then bail left, 5 count!
RT (in my bailout path): Oh, no you're not bailing left!
ME: I'm 250 pounds, I'll win, I'd move. Get ready, Chris!
RT: Scoots the hell out of the way.
CHRIS: Okay, you're good.
ME: 5...4...3...2...1...GO! takes flying leap off the left side of the bed and narrowly avoids skidding into a nurse as he lands in a small puddle of vomit.
Our beds are built to hold 700 pounds. I'm going to put in this little bit of free advertising for Stryker - We had a 400-ish pound patient, a 250 pound tech and a 200 pound tech...850 pounds, and it held. I'm suitably impressed and I'll be telling our Stryker rep so on Wednesday.
The other CNA who's helping us hasn't had her cherry popped yet, so she sidles up to me just after I bail and says "I've never done this before..." in a very sheepish voice. I looked at her and said, "Well, there's a first time for everything. Just look at him as a big, slimy, stiff CPR dummy." Nonetheless, I stood at the head and coached her through her first time. Once you get over the hump of doing it once, every time after gets easier.
Two last points. I don't know what it is, but every time I do CPR, the guy has always had noodles for dinner. And for some reason, unknown to anyone, God likes to torment me by having a noodle coming out of the guy's nose...ew...
And last, I think they need to modify the CPR class. First, take the little pussy spring out of the CPR dummies and replace it with a shock spring from a Corvette, so chest compressions feel like they're supposed to. Next, add in crackable ribs. If you don't hear crunching and popping and snapping, you're not doing it right. Take it from me, wolflings, you WILL crack ribs. Next, go buy some of that green slime, mix in some cooked ramen noodles and some fake blood and pour it over the dummy just before they start. Last, have everyone screaming in the background, nurses, doctors, family...
It's a whole different world when it's for real, but if you've done the class enough, it just takes over.
So that was my day yesterday. We didn't clear out the waiting room until 3:30 in the morning. It was really damn busy.
Take care my little wolflings.
So, I have this thing with fire trucks. Every time I see one at my hospital, it's like a raven sitting on the top of the ambulance bay croaking, "Nevermore!" They're bad omens. Every time one has been there, we've gotten screwed...sideways...with no lube. Anyway, there was a fire truck in the bay last night when I got to work. I should have stopped there. I walked into the ER and see people running like mad to our cardiac / trauma room...should have stopped there. The charge nurse looked over at me and in her sweetest voice said, "Maaaat? Can you do me a huge favor?" The pleading look in her eyes should have been my last warning.
At the exact moment I walked in the ER, we had a cardiac arrest, an active MI (heart attack), a spontaneous pneumothorax being chest-tubed by the surgeon, and every room full. The titanic is foundering. Add 15+ people in the waiting room... Sinking... So I start in trying to get report from the person I'm relieving as they guy in the cardiac room (15) starts heading downhill...pulse of 35...30...25...20...20....0. Oh shit. Titanic's tail is in the air! And...the radio goes off with 2 more sick ambulances coming in...Titanic...Sunk. F**k.
We have this code in the hospital, called a Code Blitz. It was introduced about 6-8 months ago as a quick way to deal with surge capacity. Basically, you call it, and everyone who can possibly come from anywhere in the hospital comes and helps out. Problem is, it was introduced and then forgotten about. But we remembered it. Aha! A lifeboat! I pick up the phone and call "CODE BLITZ ER STAT!" About 20 seconds later, the phones start ringing. "What's a code blitz?" After I got it explained to everyone that called, the operator, who misheard it, called a code red (fire) in the ER. Then she called a code blue (cardiac arrest), which is closer, in the ER. So as far as any visitor knew, the ER was having a really, really ,really bad day. At least it cleared the waiting room a little, as some of our frequent flyers decided that the wait just became too damn long.
We had a great response, though. We got 5 extra nurses and 4 extra CNA's, 2 housekeepers, one engineer, and another fire truck. So by the end of the next 30 minutes, we had a total of 15 nurses, 6 CNA's 3 techs, 2 EMT-B's, 1 EMT-I, 2 EMT-P's, 2 housekeepers, one engineer and 4 firefighters, all of whom we put to work.
Just after I call the code blitz, I hear "GET A RECORDER IN HERE!" so I pick up my pad and paper and run in to see another of our poor techs doing chest compressions on this 400+ pound guy. He's been going for about 2 minutes, and he's starting to flag. So I hand off my notepad to a nurse, put on a pair of gloves and take over. We switch off every minute or so while everything else goes on around us. At one point the doc couldn't see to intubate so she told the nurse to raise the bed.
Now, when you're doing CPR, your mind rather goes blank. All that matters is compressions. There is nothing else...no noise, no speaking, no thought, just counting and pushing. The person you're doing it to even really ceases to be human. I know that sounds horrible, but that's the way it works for most people. All of a sudden, he's going up...up....up, until I'm doing compressions with my arms straight out in front of me, using only my triceps. I've got good triceps, but damn. And all I can think is God damn it, now I look like I'm doing CPR in a bad medical drama!
The only think I can think of is to get up on the bed. So I get the other tech to spot me, just as another CNA walks in the door. Great! More relief! Quickly, I climb on top of the bed, wedge one foot under each side of the guy's belly and start going to town. I seem to remember one of the RT's (Respiratory Therapist) saying "That's so ER!" Finally, I'm starting to wear out, and I start to come back to reality to tell Chris (the other tech) that I have to bail. He climbs up behind me... (I should insert here that I had my knees almost locked and I'm bent at the waist to deliver compressions, which has the odd isometric effect of thrusting my hips out a little behind with each compression)...as close as he can get so when I bail, he's right there. At this point I'm thinking..."All I need right now is for the family or the local paper to show up and see this" since, according to my imagination, and apparently to the other Unit clerk watching the CCTV monitor, it must look like me and this other tech are having a little too much fun on top of this dead guy.
ME: All right, Chris, I'm going to count down, then bail left, 5 count!
RT (in my bailout path): Oh, no you're not bailing left!
ME: I'm 250 pounds, I'll win, I'd move. Get ready, Chris!
RT: Scoots the hell out of the way.
CHRIS: Okay, you're good.
ME: 5...4...3...2...1...GO! takes flying leap off the left side of the bed and narrowly avoids skidding into a nurse as he lands in a small puddle of vomit.
Our beds are built to hold 700 pounds. I'm going to put in this little bit of free advertising for Stryker - We had a 400-ish pound patient, a 250 pound tech and a 200 pound tech...850 pounds, and it held. I'm suitably impressed and I'll be telling our Stryker rep so on Wednesday.
The other CNA who's helping us hasn't had her cherry popped yet, so she sidles up to me just after I bail and says "I've never done this before..." in a very sheepish voice. I looked at her and said, "Well, there's a first time for everything. Just look at him as a big, slimy, stiff CPR dummy." Nonetheless, I stood at the head and coached her through her first time. Once you get over the hump of doing it once, every time after gets easier.
Two last points. I don't know what it is, but every time I do CPR, the guy has always had noodles for dinner. And for some reason, unknown to anyone, God likes to torment me by having a noodle coming out of the guy's nose...ew...
And last, I think they need to modify the CPR class. First, take the little pussy spring out of the CPR dummies and replace it with a shock spring from a Corvette, so chest compressions feel like they're supposed to. Next, add in crackable ribs. If you don't hear crunching and popping and snapping, you're not doing it right. Take it from me, wolflings, you WILL crack ribs. Next, go buy some of that green slime, mix in some cooked ramen noodles and some fake blood and pour it over the dummy just before they start. Last, have everyone screaming in the background, nurses, doctors, family...
It's a whole different world when it's for real, but if you've done the class enough, it just takes over.
So that was my day yesterday. We didn't clear out the waiting room until 3:30 in the morning. It was really damn busy.
Take care my little wolflings.