Fifty seven

57

"Motherfucker wait for us to get clear, goddammit!"

Working a code/code blue/cor-0 awhile back (about a year ago) It's going smoothly enough. The pt is a young (under 40) female who all of the sudden went into v-fib in her room. No history of cardiac problems just had a sense of malaise for the week prior to her visit to the ER. One minute she is talking the next she ain't.

We pull her into the big room with all the fancy equipment that goes "bing" etc. A new nurse is insisting on being on the defibrillator, they say they've never done it before. We are in a slight rush so no one argues, the assumption is made that since this nurse has ACLS that they know to "clear" the patient before shocking. We've all been new once.

Pads are attached (not paddles have not seen paddles used since circa 2004) and a quick rhythym check as per the doc. Vfib...yay..SHOCK.

Unlike TV we make sure everyone is totally clear of the patient before shocking because well you can at the very least give a co-worker a nice electrical shock at the most kill a co-worker if they are not clear (touching the patient). I have not had it yet but I would NEVER want to work two codes because some ass hat did not make sure that everyone is clear when the pt is getting a shock.

so vfib...yay....shock patient....charging....clear patient...

This is when everyone in the room says "CLEAR" and steps away from the patient, the person doing the shocking looks over everything and delivers a shock to the patient. It always works that way until it does not.   

So is the case here. Defib nurse is concentrating on the machine (back turned to all of us including pt) and not making sure the pt is clear, I'm grabbing people on my side of the patient to make sure they are clear of the patient and without not even a "clear patient" a shock is delivered.

The RT and airway resident are nearly shocked. The attending scolds the nurse and says be more careful if we need to shock again. CPR continues and the next round of ACLS drugs are given. We are digging in the pt is a young female so with no history and we've gotten a shockable rhythm already. It looks good.

We stop for a pulse and rhythm check no pulse but vfib again...Doc says shock. Again the nurse turns his back on the patient and everyone else and "BOOOOOOOOOPPPPP" charges the machine then with no warning shocks the patient.

Fortunately we are all paying attention from the last close call and we are all clear. Someone in the room (not me) yells "Motherfucker, pay attention goddammit you nearly shocked the entire code team" (I think it was the attending) It's not my turn to do compressions and turn to plead with my eyes to the nurse beside nurse itchy trigger finger to change places with him. She does not see my pleading eyes. I just don't wanna die today from someone not paying attention.

Again another round of compressions and drugs and two minutes are up  we all look to the monitor and thank the heavens the pt is NSR (a good thing) at around 70 bpm. At this point various drips are set up and the call to the ICU is made.

I pick up a roll of 2 inch cloth tape and throw it at nurse itchy trigger finger's head. He barely ducks in time and asks why I did not warn him I was throwing tape at him. To which I reply, why did you not warn us you were shocking first. The nurse is later taken aside by the charge nurse and "counseled" on how to administer a shock to a patient in a shockable rhythm. It was the closest I ever came to punching a co-worker ever because of their gross negligence.

Pt lived and made it up to ICU. Nurse itchy trigger finger is still on staff and is watched very closely during codes now especially if he gets near the defibrillator.

Take care and Happy new year!