your first "patient emergency"

9 I've called "rapid response" on patients before, but never on anyone in my direct care. Today, my patient called out, complaining of n/v. I came in, and although I didn't note anything funny, there was something about him that just didn't seem right. I questioned him as to what was going on and he spaced out. Just like that, the right side of his body started twitching. Instinctively, I looked at the clock as I told the CNA to get another nurse. What followed actually flowed pretty perfectly in my opinion. We got vitals, he stopped seizing after ~5 minutes, I called the doc, filled out paperwork and gave him a stat dose of Dilantin, with labs to be drawn in the morning. I was certain that I would have been more freaked out at the onset of the seizure, but I stayed calm.

I hope that he's either better when I get back on Tuesday or they ship him out (I'm in LTC/rehab). Either way, I came home knowing that I made a difference today!

I was in psych before, so I've handled "behavioral emergencies" but nothing medical like this!

Anyone else want to share their "first"?
Well done! It's kind of fun when it all makes sense doesn't it?

Quote from Esme12Well done! It's kind of fun when it all makes sense doesn't it?

((HUGS)) good for you......see critical thinking eventually clicks. Congratulations!~

Yes... I was about to start a topic just like this! I had two cases yesterday where I've wondered, should I call a rapid response right now?! However in each case we managed the symptom, the patients recovered, I never lost my cool (most amazingly of all!), and I felt like each was handled well, IMHO. *sigh* such a good feeling!

There was a nurse who gave a pregnant patient indocin on the floor and she was allergic to aspirin. The nurse didn't wait until pharmacy cleared it and the patient went into anaphylactic shock. I was so calm cool and collected while in the situation and did all I was told and did things I didn't even know I knew as well. The baby and the patient fully recovered after some epinephrine, Benedryl, and the rapid response team, but after the situation was all over I was a shaky mess. But I held it together while in there. You never truly know what you are capable of until you find yourself in a situation like that.

I don't remember my first, but I remember one of my orientees' first. We were in the ICU and the patient started to report chest pain and shortness of breath. She listened to his L chest and said, "I don't hear anything on this side." I saw the tracheal shift, thumped on his L chest (hollow) and called the stat response, while sending the aide to the storeroom for the chest tube tray and a new pleurevac (we had pleurevacs in those days) and had it all set up by the time the resident flew in the door. Patient had his chest tube in for his spontaneous pneumo in about four minutes flat from the time he had his first pain.It is fun when it all comes together, ain't it? It's what we stay for sometimes.

I had my first patient emergency a couple weeks ago. My patients sats started dropping so I entered the room figuring the monitor had gotten partially dislodged from his finger or he had apnea. His sats were 75% and I called his name, rubbed his chest...noticed his sats continued to plummet. I hit our staff assist button and grabbed the ambu bag and lowered the HOB. He was in agonal breathing; charge nurse and additional staff came in and a code was called. He had a pulse and began breathing again. Tons of people responded and he stabilized; then passed the next day on a different unit. The experience was surreal and I remember thinking in slow motion, yet moving quickly. It made me very thankful for the incredible team I work with and the training I've gotten. A good plus is I feel more prepared for the next emergency. Great thread; interested in hearing from others.

I very clearly remember my first emergency - it was during my externship in the summer between my junior and senior years of nursing school. The day nurse for this particular patient had an extern with her and I was extern with the night nurse who was getting the patient in report. The patient called out to say that he had to go to the bathroom, and the CNAs were busy so they sent the externs in alone. We had maybe been on the job 3 weeks, and neither of us had ever worked as CNAs before so we were very inexperienced. When the patient was finished voiding we transferred him back over to the wheelchair from the toilet. We started to roll him out of the bathroom and he slumped over and was incontinent of urine again. The other extern froze, but I shook him and tried to get him to respond, and when he didn't, I told the other extern to stay with him and I hit the code button and got help in the room. The nurses and the code team got in the room around the same time; they had apparently been helping another patient. The nurses of course had no idea what had happened so I was the person telling them the story of how he went down, what he looked like, etc. The code team leader stated that he needed someone to push meds and he looked at me first, I guess assuming I was the nurse because I had my stuff together while my preceptor was freaking out on the other side of the room, and I had to explain that I couldn't do it. I even got to do chest compressions for a couple of rounds.I had thought I wanted to be an ICU nurse before, but that rush I got being the person who recognized the emergency and called the code, talked to the code team, and actually did compressions reinforced it. I LOVED that feeling. The guy lived through the first round of CPR, but he coded later in the ICU and died. I am still proud that I helped save his life once, even if it was only for a few hours. I know all of nursing is important, but that feeling of recognizing that emergency and literally pounding the life back into someone is awesome.

Mine was as a intern in a cardiac stepdown unit. Guy was going in for cath that morning so we were starting his second line, he was a horrible stick and his first one went bad too. So right as I am about to start his IV I tell him ok here it.........asystole. Pt went slump stopped breathing no response. I got bugged eyed looked at my preceptor, he yells out for one of nurses in the hall, I manage to get the IV just as the seasoned nurse comes in, we tell him what happened. So Mr seasoned as the earth is old nurse comes in looks at him and WHAM hammer fist to the chest. Pt wakes up and says "where did I go just now?"Thank god it was at 630 in the morning and I was about to go home. Great learning experience about how to keep calm under pressure though

I don't remember my first rapid response. The first one that sticks out in memory though was when I when I was a fairly new grad working pediatrics and my patient came out to the desk and calmly asked me to come into her room. I went in to find her mother sitting in the chair having a grand mal seizure and barely breathing. I started freaking out and grabbed my charge nurse who grabbed one of the pediatricians at the desk. We ended up coding her for a while. Found out the mom hadn't taken any of her meds for seizures, blood pressure, or diabetes during the several days her daughter was in the hospital. We got her back and transferred to the adult hospital. I was worried the kid would be freaking so after it was all over I went to ask her if she wanted to talk about what had happened. She was like "nope, mom does this sort of stuff every week.".

My first and second patient emergencies were with the same patient, 2 nights in a row. The first night I had just finished rounding on my rooms and was sitting down to chart. About 15 minutes in I got super restless and had to get up, I went to my patient's room at the other end of the unit, where I noticed a dark puddle on the floor. She had pulled off the line and cap to her large gauge IV and was quietly exsanguinating in her sleep. I'm not sure how long she had been bleeding (less than 15 mins obvi) but it was bleeding really fast so probably not long. EBL was 1500ccs in an already post-op patient. I had the sense to pull the line and apply pressure but shouted for help waking half the floor instead of using the call bell.The next night on my initial assessment she had an acute abdomen; she died later that night of a post-op complication. I still remember her name, age, diagnosis, face, nightgown. I learned a lot about how to stay calm under pressure from this lady, I will admit at one point on the second night I thought "well, it's a lot better for me that I caught it last night, but maybe I didn't do her any favours."

I remember my first "patient emergency" like it was almost yesterday. While I was not a nurse at the time, I was most certainly in a patient care role…This patient is now long gone, at the time she was 93 years old in a board and care facility. In fact, this was a 911 call. The fire department got there, did their assessment, they were BLS, as were we at the time. According to their assessment, she was unconscious, unresponsive, was breathing, and had a pulse. By the time I did my assessment, she was VSA. In other words, she was in full arrest, and a full code. She was also my first CPR patient. I called the code, started compressions, got the firefighters to assist with moving the patient to our gurney, and we initiated transport to the local hospital, where we continue to work the code for a long time, probably forty-five minutes or more. She did not survive despite our efforts.What I did take away from that experience is that even though I was very new at the time, I was trained well enough to not panic and get things done. I have since worked quite a few codes, and most of them have blurred with time... There are, of course, a couple of memorable ones but along the way I have certainly come to understand that I simply just do not panic during an emergency and I just do what needs to be done.Clearly though, most of those did not occur in a very short period of time, rather that all took place over the course of some seven years of service in EMS. Fast forward a few years later and I still do not panic during an emergency. It does however give me a very good perspective when some of my classmates have had their own. In my opinion one of my classmates, in doing a very good assessment of his patient, prevented the code and called the rapid response team to assess his patient and had he not done so, I think the patient ultimately would've had a very poor outcome from the get-go. Given the situation and the fact that he had never been in any sort of emergency situation before, I think I actually was prouder of him with his decision that I was of me making similar decisions in the past. Perhaps that was because he is still in a student mode of thinking and at the time I was already working in EMS, fully trained and expected to perform at a fairly high level.