Monday, April 10th, 2017

Electrical Accidents Are Not Really Fun

December 28, 2010 by  
Filed under CNA Training

I learned some of these rules by force, and others have learned from the misfortunes of others.

• When defibrillation is a prisoner in custody, do not forget to take off his wrist and ankle chains before using electricity. This is particularly important if the prisoner is chained to a metal bed frame. And if the respiratory therapist leaning against the bed frame to bag the patient. If you discover that you forgot to remove the strings before defibrillation does not scream“Oh My God, those shackles have to come off right NOW!” Causes prison guard to rush with his (metal) to try to remove obstacles RIGHT NOW. Fried therapist is one thing, prison guard fried is another. Now you have successfully taken a prisoner in custody, only the goalkeeper is in the ER being treated for injuries when you accidentally defibrillation HIM. (Although I did not at least say that fried respiratory therapist is a good thing or even something OK!)

• Do not allow the trainee to paddle, but above all, do not allow the trainee to maintain the blades in the month of July, when they are all Gung Ho and ready to save the world. Certainly do not allow them to keep the blades before they had run their course and ACLS have learned to shout “Clear”and seems to really make sure that everything is clear before shocking. senior nurses, who may be upset to go to life-threatening arrhythmias, and suddenly you have two hands on the code instead of one. Do not allow the student to execute code (or accompanied by an ER) nurse, who has just shocked. Some managers simply do not take that sort of thing very well.

• Understand that some types of codes are more likely to leave in the hands of other types, but the electrical safety must be maintained independently. If the patient is the husband of a cardiologist office receptionist, especially when young, the code is likely to continue for a very long time, and it is possible that different substances leaking fluid on the floor. Blood from the center line just dropped, but I forgot to connect it to anything, the IV of IV fluid that was supposed to be connected to the center line just set but somehow overlooked the screws, and the infusion of adrenaline attached to the centerline of another guy who just accidentally deleted all the pools are under the bed. If this is an old hospital building, it is possible that there’s a mouse under the bed. A mouse trapped in a puddle of fluid under the bed in a very long code can be electrocuted. Seriously. This is a solution to the problem of rodents, but not a good solution.

• If the patient is wet, trying to dry a bit before attempting defibrillation. It is also preferable not to defibrillate the patient is in a puddle. (Patient encoded in the bathtub, but that’s another story.) If you decide whatever stupid reason to defibrillate a patient lying in a wet puddle of water for bathing, not for any reason whatsoever kneeling in the bath water when you do. Not significant staff kneeling in the bath water either. If anyone should be kneeling in the bath water, it is probably just as well he was a trainee – the youngest person and healthier in the group and therefore most likely to recover experience without lingering effects.(Probably even the least important person, but that’s another story.) And when you do stupid defibrillate a patient lying in a wet puddle bath and accidentally shock intern in the process, no case be heard to comment “WOW! That was really cool”, which sank on the patient in a visible, colored nails.

• When lifting a bed highest position, so be sure to note the attached IV pole is compared with standard fluorescent lamps. If by chance you forget that, and the IV pole through the ceiling panel and ceiling lights off, causing a spectacular light show extrememely noise and glass shower occurs, you must not in any circumstances, be heard to comment “Wow! That was really cool.”Especially if you are a patient in bed, especially if management (or nurse educator) is far away.

• Be careful with your patient before attempting defibrillation, although the majority of fatal arrhythmias. If the monitor says fib V, but the patient is talking on his cell phone while scratching his armpits, the monitor could be wrong. In fact, it is likely that the monitor is bad. That’s good follow-up, adjust the line pressure can be another clue. If you can defibrillate (or allowing a resident of the defibrillator) device, please do not in any case be heard muttering “no harm, no foul.”