Tuesday, 23 March 2010

My First - Arrest

Technically this wasnt my first arrest, but it was my first arrest working on A&E and as a student nurse this meant I had a greater potential to effect the outcome of this arrest.

I was working in A&E resus with my mentor, and the red phone(commonly called the bat phone) rang. This phone is only dialed by ambulance crews telling us they are bringing a majors or resus patient. We took the details of the patient as follows -

44 Year old. Male. In cardiac arrest on arrival. Non-shockable rhythm. Resuscitation started on arrival. Four previous MI's. High BMI. ETA 4 minutes.

There were other details but the purpose of this post they were irrelevant. I started preparing the space we would bring hte patient into. Turning on the AED(defib). Making sure the cardiac monitor, blood pressure and pulse oximeter cables were all untanlged and the machine they were all connected to was on. I cracked open a high flow o2 mask and started it on 15L. Whilst I was doing this my mentor was beeping the crash team. We then gowned and gloved up. I made sure the board was clear and the board markers were working. Scribing is vital to clear, fluid resus attempts. Just before the ambulance crew came running through the emergency doors and the crash team came running down the corridor, my mentor looked at me, smiled, told me to take a deep open breath and remember this "No matter what happens, even if you do everything wrong, this man is dead, nothing you do can make the situation any worse for him". I still dont fully understand why but his words have come to my mind during every arrest I have attended since and they have kept me calm.

The resusciation attempt wasnt as hard as I was expecting, I stayed calm, and there was very little thought involved. My mentor took charge of everyone present, even the doctors. My body reacted to the voice of command and I found everything else was muscle memory and instinct. The patient did not survive however a study performed in london a few years ago suggested that when it comes to pre-hospital arrests, even if the crew arrive quickly and a first aider starts cpr as soon as the arrestee drops there is still only a 1 in 185 chance that the patient will survive to be discharged from hospital. I would imagine the odds are a lot worse for people who arrest with a non-shockable rhythm(Asystole or PEA). The hard part is thanks to all these medical drama's on tv every patients relatives expect you to raise the dead.


Sage said...

Happy Birthday dear blogging friend, have a nice day xx

皓云 said...
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