A patient progressively decompensated during a procedure in another area of the facility requiring rapid response and then code team response. Upon arrival to the SICU, he had been intubated and multiple vasoactive continuous infusions were employed to maintain his blood pressure. The MICU resident leaped into action and secured central venous access while anesthesia ensured an arterial catheter was placed to allow for more effective titration of these infusions. Despite the best efforts of the team, the patient continued to rapidly decompensate to the point of arresting which led to multiple other arrests. Assets from all of the facility were required to maintain effective compressions, deliver life-prolonging drugs, gather supplies, document, and ensure airway management. Physicians, nurses, respiratory therapist, pharmacy, and multiple attending and fellows engaged in all aspects of care.
Through solid communication and teamwork, multiple codes were executed over an hour and a half. Ultimately, the patient succumbed to the pathological process taking place, but it was not for lack of effort. Attendings from Medicine, Pulmonary and Critical care and Anesthesia all played vital roles in directing the care of this patient and providing suggestions but were open to input from all involved. The team was applauded by the Pulmonary Fellow and Attending for the efforts that they put into this Veteran's extraordinary resuscitative efforts and called it "remarkable". Upon the patient's death, staff not always engaged in direct patient care assisted SICU staff in preparing the patient's body for the morgue and the patient's eyes were to be donated to the state's organ procurement agency. Upon arrival of the patient's family and loved ones, it was noted that the significant other had a visual disability making the donation all that much more significant. Nursing staff in SICU did their best to comfort the family in their time of grief and loss which was later communicated as being very assuring. Later, his body was delivered to the morgue shrouded with the flag of the United States of America. In transit, all staff and folks walking in the hallways stopped and gave the entourage the right of way with proper respects. The chaplain assisted in the ceremony of folding the flag and returning it to SICU.
Team Members honored with this DAISY Team Award:
Auryelle Ascue, RN
Jamie Sicard, RN
Mark Frazer, RN
Don Studt, RT
David Deen, Pharm D
Laura Juul, MD
Gearin Broderick, MD