![]() After minutes of trying to determine the cause, it was discovered that the mask had been attached to the oxygen nozzle on the wall, but the oxygen had not initially been turned on by the nursing staff. Moreover, despite ventilation with the bag-valve-mask, the patient's saturations remained less than 80%. In the meantime, the patient remained pulseless with an uncertain rhythm. The team did not have appropriate leads to connect the monitor and sent a nurse back to the main hospital to obtain compatible stickers. ![]() Unfortunately, the leads on the monitor were incompatible with the stickers on the patient, which were from the psychiatry floor (the stickers were more than 10 years old). When the critical care nurse and the rest of the code team arrived, they attempted to hook the patient up to their portable monitor. The resident and intern began basic life support (CPR with chest compressions) with the bag-valve-mask. The nurses on the inpatient psychiatry ward had placed an oxygen mask on the patient, but the patient was not receiving ventilatory support or chest compressions. Upon arrival minutes later, they found the patient apneic and pulseless. So the senior resident and intern ran down numerous flights of stairs, outside the front of the hospital, down the block, into the psychiatry facility, and up four flights of stairs (the two buildings are actually connected on the fourth floor). "I don't know how to get there except to go outside and through the front door," a colleague answered. "How do we get to psych?" the senior resident asked a few other residents in a panic. ![]() The senior resident and intern had never been to the psychiatry facility. The message blared through the overhead speaker system, "Code blue, fourth floor psychiatry. Thus, the "code team" (comprising a senior medical resident, medical intern, anesthesia resident, anesthesia attending, and critical care nurse) within the main hospital was activated. The inpatient psychiatry facility is adjacent to a major academic medical center. ![]()
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