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Infusion rooms should drill nurses, staff for anaphylactoid emergencies
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ORLANDO — All infusion suite staff, including nurses and physicians, should participate in code drills to help them prepare for anaphylactoid reactions, heart attacks or any other adverse events that could arise while administering the treatment, according to Timothy R. Walker, RN.
“You need to be trained to intervene in the event of an anaphylactoid reaction, so have everything that you need to do so,” Walker told attendees at the 2019 Rheumatology Nurses Society Annual Conference. “Don’t get caught unawares.”
“I’ve been doing this for 10 years and I’ve only had to full-code someone one time, and that was one time too many,” he added. “It had nothing to do with us – the patient walked in with a cardiac history. She walked in to my suite, sat down and said, ‘I feel funny’ and had a full-blown, MI cardiac event. And then she was gone. Dead. Gone.”
Walker, who is the infusion suite coordinator at Piedmont Arthritis Clinic, in Greenville, S.C., walked into the infusion room after the code was called, and promptly took over administering CPR. After three rounds, he could feel no pulse and the patient was beginning to turn gray.
However, after another round of CPR, she started breathing again and recovered.
“Everything was fine, everything was dandy, but what I discovered is that even though you have this training, and you have your certification, have a drill,” Walker said. “We have fire drills, so have a drill for this, because what I discovered was that while I’m down there doing one-person CPR, I’m surrounded by certified people and not one them got down there with me. They watched. And I – so wrapped up in what I was doing – didn’t start issuing orders.”
“I didn’t say, ‘You, start an IV. You, go to the front door to guide them in. You, clear these people to that side of the room. You are in charge of the room,’” he said. “I didn’t issue orders, because I was wrapped up in, ‘30 and two, 30 and two, 30 and two.’”
According to Walker, infusion staff members should organize drills and then review the results afterward and discuss what can be improved. Everyone in the infusion center should know what their role is in the event of a code, he noted.
“So, practice – please practice,” he said. “Have drills and get your physicians in on it. Then, when you are done with your drill, do a follow-up talk about how you can improve that, because I guarantee it’s not going to work the way it does on TV, where everyone jumps into action. When people hear the code called, they will come running into the room. Give those people something to do, and say ‘please.’” – by Jason Laday
Reference:
Walker TR. Essential Infusion Therapy Skills. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 7-10, 2019; Orlando, Florida.
Disclosure : Walker reports no relevant financial disclosures.