The CPR Medical Emergency Response committee reviews all emergency calls for statistical data, quality improvement, learning opportunities, and safety concerns. We also debrief and check in with team members to see if they have questions or require support. I was doing follow up on a weekend code team call. Luckily, the patient achieved ROSC (return of spontaneous circulation) and survived the resuscitation effort. I talked to some of the code team responders to learn what went well, what could have been better. Overall, it was a well-run code with early local response and strong team leadership by the ROC. When I debriefed with the patient's nurse, Meeghan, I got to hear her story of how she helped saved her patient.
This patient had some preexisting medical issues, fever, and high blood pressure, lethargy to name a few. Meeghan's inner nurse was telling her something was up with this nonverbal patient, and she would need to keep a close eye. She was already planning to follow up with the physician with an SBAR/CUS briefing. But first, she had to finish her morning med pass and send this patient for a chest x-ray as part of a "fever" work-up. During this time, the patient's bed required replacement, so upon return from x-ray, the bed was not quite ready. Meeghan decided to leave the patient on the cart in the hallway for safety and closer surveillance until the bed was ready. She checked on the patient, and things appeared stable. Just two to three minutes later, Meeghan looked over to see the patient had lost all color and was unresponsive. She quickly pushed the nearest emergency light while calling out for assist and requesting a code team call. She initiated compressions immediately while waiting for responders to arrive. She remained calm and performed compressions until others could take over. Meeghan was able to provide hand-off to the ROC while the rest of the code team assumed their roles.
This was, of course, a team effort, but thanks to Meeghan's intuition, and critical decision to keep this patient close by for surveillance, there was an opportunity for an early CPR rescue. Her calm demeanor combined with her timely and effective CPR skills helped achieve a positive outcome.
Other code team responders and co-workers were not surprised that Meeghan sprang into action so quickly. "That's just Meeghan" they said. They know her to be a reassuring presence in an emergency, having the knowledge, skillset, and fearlessness to step in and step up when it is needed most.