Float Nurse

Life is pleasant. Death is peaceful. It's the transition that's troublesome. Wise Phrase by Isaac Asimov 1016 PM:  A 27 year old female is dumped out of a car in the entrance to the ER.  The car drives off.  She is unresponsive with agonal breathing.   She is placed on a stretcher and rushed to the trauma room.  During her assessment she is noted to have a white powdery substance around her nostrils.   Her pupils are constricted and nonreactive.  Her skin is hot and dry.  The peripheral pulses are weak with delayed capillary refill.   Positive pressure ventilations are started and she is placed on the monitor.   1022 PM:  An IV is established and blood specimens are obtained.    Spontaneous respirations and her pulse is now absent.   CPR is initiated and Epinephrine 1mg IV is given 1026 PM:  CPR continues with positive pressure ventilations.  IV fluid bo...

"And, has thou slain the Jabberwock? Come to my arms, my beamish boy! O frabjous day! Callooh! Callay!' He chortled in his joy. JABBERWOCKY  by  Lewis Carroll 1500:   An 82 year old female with pneumonia and exacerbation of  COPD.   Monitor alarm heard for heart rate less than 50.   Patient found unresponsive with agonal breathing.   Rapid response called.   Positive pressure ventilations given to the patient.   No improvement in patient with ventilations.   Unable to obtain pulse.   Code Blue called. CPR rhythm  1506:  Epinephrine 1mg IV given.  CPR in progress with positive pressure ventilations. CPR rhythm 1508:  Rhythm check.   No pulse detected. PEA rhythm CPR rhythm 1508:  CPR in progress.  Difficult to ventilate.  Abdomen very distended.  Nasogastric tube inserted and stomach decompressed.   Ventilations improved. ...

“All their life in this world and all their adventures had only been the cover and the title page: now at last they were beginning Chapter One of the Great Story which no one on earth has read: which goes on for ever: in which every chapter is better than the one before.” ― C.S. Lewis, The Last Battle A 65 year old that got choked while eating and developed a complete airway obstruction.  EMS was dispatched to the scene.   BLS and ACLS measures with placement of an advanced airway were initiated at the scene.  Twenty minutes have elapsed since the patient collapsed.  CPR is in progress when the patient arrives.    Initial Rhythm with CPR in Progress CPR Rhythm Epinephrine Given During Compressions CPR Rhythm Rhythm Check PEA Rhythm Epinephrine Given During Cardiac Compressions CPR in Progress Rhythm Check Epinephrine Given During Cardiac Compressions Rhyth...