June 2014
Chrissy
Lockhart
,
RN
Float Pool
Winchester Medical Center
Winchester
,
VA
United States
Situation: Mrs. S is a female who was at Winchester Medical Center coming to visit a family member in the Step-Down Unit. Mrs. S stepped out of the third floor elevators and suddenly collapsed. A visitor had witnessed this and reported the incident to an employee who came and asked me to help someone who had fallen in the hallway.
Background: At the time of the event there was no way to obtain any medical history as the patient was alone and unresponsive. Later it was found out that the patient was a 53 year old female with no significant medical history. However, the patient was under a great deal of stress as she was acting as the primary care taker for her very ill husband and now her sister who had become critically ill.
Assessment: Upon arrival to the patient, it was clear she was not someone who had just fallen. She was lying on her back, motionless, and did not appear to be breathing. There was a security guard on the floor beside her trying to arouse the patient without success. A CNA from the floor had followed me to the hall and I sent her for an AED and help. I checked for a pulse, which was absent, so I started compressions. A few minutes later, Rapid Response arrived and called for the MERT team for a code blue. A monitor was then brought and placed on the patient which revealed the patient was in v-fib. The patient was defibrillated twice and returned to normal rhythm with a pulse. The MERT team and an Emergency Room Physician then responded and the patient was intubated and taken to the Emergency Room.
Results: The patient had a full recovery without any neurological deficits from the event. She was taken to the Cardiac Cath Lab during her stay and diagnosed with Takotsupo Cardiomyopathy (aka "Broken Heart Syndrome"). The patient did get an implanted cardiac defibrillator before leaving the hospital. This patient is a great example of how initiating CPR and early defibrillation can restore perfusion and save the patient's life.
One must go above and beyond the fact this was a code event, reviewing the multiple obstacles that Chrissy Lockhart had to overcome to vision the true DAISY. Finding the 53 year old female unresponsive, Ms. Lockhart took full ownership of the situation, showing the value of a Magnet Nurse, assuming autonomy and initiating one person BLS CPR. This event did not occur in an optimal area like a patient's room with doors for privacy or the convenience of a code blue button. Elevators continued to stop allowing access to visitors and patients. At no time did this interrupt Ms. Lockhart, even when family members exited the elevator witnessing the event. The defibrillator pads were laced under the clothing giving the visitor privacy while maintaining her dignity. Code events are very stressful to all involved. This is an example of dedication to the nursing profession and the community.
Background: At the time of the event there was no way to obtain any medical history as the patient was alone and unresponsive. Later it was found out that the patient was a 53 year old female with no significant medical history. However, the patient was under a great deal of stress as she was acting as the primary care taker for her very ill husband and now her sister who had become critically ill.
Assessment: Upon arrival to the patient, it was clear she was not someone who had just fallen. She was lying on her back, motionless, and did not appear to be breathing. There was a security guard on the floor beside her trying to arouse the patient without success. A CNA from the floor had followed me to the hall and I sent her for an AED and help. I checked for a pulse, which was absent, so I started compressions. A few minutes later, Rapid Response arrived and called for the MERT team for a code blue. A monitor was then brought and placed on the patient which revealed the patient was in v-fib. The patient was defibrillated twice and returned to normal rhythm with a pulse. The MERT team and an Emergency Room Physician then responded and the patient was intubated and taken to the Emergency Room.
Results: The patient had a full recovery without any neurological deficits from the event. She was taken to the Cardiac Cath Lab during her stay and diagnosed with Takotsupo Cardiomyopathy (aka "Broken Heart Syndrome"). The patient did get an implanted cardiac defibrillator before leaving the hospital. This patient is a great example of how initiating CPR and early defibrillation can restore perfusion and save the patient's life.
One must go above and beyond the fact this was a code event, reviewing the multiple obstacles that Chrissy Lockhart had to overcome to vision the true DAISY. Finding the 53 year old female unresponsive, Ms. Lockhart took full ownership of the situation, showing the value of a Magnet Nurse, assuming autonomy and initiating one person BLS CPR. This event did not occur in an optimal area like a patient's room with doors for privacy or the convenience of a code blue button. Elevators continued to stop allowing access to visitors and patients. At no time did this interrupt Ms. Lockhart, even when family members exited the elevator witnessing the event. The defibrillator pads were laced under the clothing giving the visitor privacy while maintaining her dignity. Code events are very stressful to all involved. This is an example of dedication to the nursing profession and the community.