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Sep
17

Clear!

Today was our pulmonary embolism simulation and it was a REALLY good learning experience because we had to do a lot!

We started out with a “patient” who had a pretty uncomplicated situation – post-op cholecystectomy (gall bladder surgery) – who took off her SCDs in the middle of the night, which is a no-no when you’re a non-ambulatory postop patient. SCDs are Sequential Compression Devices that you might be familiar with if you’ve ever had surgery – they are wrapped around your calves and inflate/deflate in cycles to keep your blood circulating and prevent the formation of clots.

As we expected and knew would happen, our patient started showing symptoms of a pulmonary embolism – shortness of breath, chest pain, decreased oxygen saturation levels, anxiety, etc. So we had to call the physician about a change of status, implement all of the new “orders” as a result of our report (stat labs, scheduling a pulmonary angiogram and starting a 12-lead ECG) and calculate and hang meds.  Then we had to call the doctor back with lab results and reassure the patient, who then became unresponsive.

The funniest/most confusing part was when we realized she was unresponsive and we needed to call a code. We all kept waiting for someone else to take charge for a few seconds and then simultaneously exclaimed “Code!”, then broke into a fit of giggles. Hey, we were nervous!  I ended up actually calling the “Code 99” through the phone, and then our job was to do basic life support until the code team arrived. A team of 1 – our instructor – but she acted as the leader and we were the code team. One person managed the airway and checked pulses, two switched off on chest compressions, and I got to push meds (epinephrine and amiodarone) and man the defibrillator.  What an adrenaline rush!

After several minutes of interventions, the team leader called it and our mannequin “died”. Mostly because there was no one in the sim control room to tweak the computer and return our patient to consciousness.

By the end we were sweaty and flushed and exhilarated! It’s one thing to practice chest-compressions on a torso in CPR class, but it’s entirely another to go through the whole process of a code. (And I’m sure even moreso with actual people.) But it was important to practice the process and understand what we as nurses/nursing students may need to do in such a situation.

And with that, I’m exhausted. Tomorrow is the first day of our capstone seminar and we will be finding out more details about clinicals. It sounds as if I’ll be in a pediatric hematology/oncology clinic and infusion center!!!!!! 😀 Not at the exact location where I decided that peds day treatment was my first choice, but the same type of setting. I will DEFINITELY take it!

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