Maydays

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Maydays

• Jan 2008

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The best way to run a code.

• Is not to have it in the first place. Know the
  reasons for cardiopulmonary arrest, assess your
  patient and have a high degree of suspicion.

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Most codes dont happen without warning..

• 70 of patients show evidence of respiratory
  deterioration within 8 hours of arrest
• 66 of patients show abnormal signs and symptoms
  within 6 hours of arrest and MD is notified in
  25 of those cases

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Medical Emergency Team

• MUHAs MET team is our rapid response team. It
  is called a MET because there is an MD component.
• Not in all areas 24/7, check with your unit for
  coverage.
• Call 2-3333 and ask for a MET

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MET Criteria

• Staff member is worried about the patient
• Acute change in blood oxygen saturation less than
  90 despite O2 fractional inspired oxygen (FiO2)
  of 50
• Acute change in mental status (delirium,
  confusion, agitation)
• New, repeated, or prolonged seizures
• Acute change in urine output to in patients without renal failure
• Acute change in heart rate to 130
  beats/min
• Acute change in systolic blood pressure to mm Hg
• Acute change in respiratory rate to 30
  breaths/min

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What is a Mayday?

• The definition of a Mayday is
• A respiratory and or cardiac emergency or any
  other situation perceived by the care giver to be
  a life threatening situation including both
  conscious and unconscious individuals
• That means you dont have to wait until CPR is
  started. If you need help, call for it!

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How do you call?

• Call the operator at 2-3333. Information to
  give
• Where you are-exactly! We have a big campus
  here, so 7th floor wont work. Tell the
  operator the room number and the building
• Adult or pediatric. We have several teams here,
  so they need to know who to call.
• Your name and call back number, so the operator
  can confirm someone responded.

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How do you call a Mayday?
All campus locations call 2-3333
Give room number and building name if you are
calling from one of these buildings
Medical University Hospital Childrens
Hospital Storm Eye Rutledge Tower Charleston
Memorial
Basic Science Building Library Building Clinical
Science Building North Tower Institute of
Psychiatry
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How do you call a Mayday?

• All campus locations call 2-3333
• For all buildings not previously listed, give
  full street address when calling a Mayday.
• For example, if you are in one of these
  buildings-

Gazes Hollings Employee Health Family
Medicine Quadrangle Cannon Place College of
Nursing College of Health Professions
30 Bee Rutledge Annex Parking garages Harborview
Tower Wellness Center St. Lukes Childrens
Research Harper Student Center
Know your street address! Keep it by the
phone!!!!!
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Mayday in the Parking lot?

• Call 2-3333 from nearest phone or 792-3333 from
  your cell phone. If outside the campus, call 911

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What do you do?

• If it is your patient
• Stay with the patient. Dont go running off for
  equipment. The Mayday Team (or other response
  teams) will need information on this patient, and
  you are the one with the info! So, dont
  disappear!
• Call for help-make sure your colleagues on the
  floor know you have a code.
• Basic life support-delegate to other responders,
  as needed.
• Compressions! Compressions !

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What do you do?

• If it isnt your patient, but you hear the call
  for help
• Make sure Communications has been notified and
  the Mayday Team is on the way
• Get the crash cart to the room. Try to plug it
  in so that the portable suction works
• Make sure the first responder in the room has
  necessary BLS equipment-ambu bag and mask and
  backboard

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What do you do?

• If you are the charge nurse
• Crowd control-make sure that the necessary people
  go into the room to help, but keep the gawkers
  out.
• Assign someone to document and be the timekeeper
• Make sure the nurse manager and attending
  physician are notified

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http//www.musc.edu/cce/ORDFRMS/pdf/cprform.pdf
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After the team arrives.

• Help them find equipment
• Crowd control- if someone looks like they are
  just looking, ask them to leave. If hallway
  becomes too crowded, call security.
• Have one person stay with the family, if they are
  present. The Chaplain can help with this.
• Make sure someone is documenting.

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May Day Question 1

• 1. A May Day is called in the event of
• A respiratory or cardiac emergency
• Any situation perceived to be life threatening
• Respiratory or cardiac arrest only
• A and B

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May Day Question 2

• 2. What is the most important thing for you to do
  if you are with a patient and a May Day has been
  called?
• a. Run to get the crash cart and AEDb. Run to
  nurses station to get help
• c. Stay with the patient
• d. Go to phone at nurses station to call
• 2-3333

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May Day Question 3

• 3. If a patient is in a life threatening
  situation but is still conscious, you should not
  call a May Day.
• T F

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May Day Question 4

• 4. The number to call for a May Day is
• a. 2-2222
• b. 2-2911
• c. 2-3333
• d. 2-0000

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May Day Question 5

• 5. After the team arrives when you have called a
  May Day for your patient you should
• Make sure someone is documenting
• Assist with crowd control
• Get someone to stay with the family
• All of the above

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May Day Question 6

• 6. MUHA has a Medical Emergency Team, MET. In
  consultation with the primary team what number do
  you call if you need to ask for a MET?
• 2-2300
• 2-0590
• 2-3333
• Your nurses station

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May Day Question 7

• 7. The criteria for calling a MET includes
• Staff member is worried about the patient
• New repeated or prolonged seizures
• Acute changes in heart rate to 130
  beats/min
• All of the above

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MUHA CRASH CARTS

• A review of the contents of the crash cart

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The Crash Cart

• We have two types of standardized crash carts at
  MUSC-
• Adult
• Adult/Ped

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Defibrillators

• We have three types of defibrillators here at
  MUSC. Know the type you use in your unit

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Crash Carts

• Crash carts are unlocked except for medications
  and airway supplies. Please review during your
  orientation and on a regular basis.
• Also, check out http//mcintranet.musc.edu/mayday
  for Mayday Information

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The Crash Cart

• Back of cart
• Backboard-dont forget!!

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The Crash Cart

• Drawer 1
• Drawer one has no designated items. Some units
  use this area for extra pads and blood pressure
  cuffs. Check with your unit.

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The Crash Cart

• Drawer 2 and 3
• Both come from Central Supply and are a single
  patient charge item.

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Respiratory Boxes

• There are two respiratory boxes at the bottom of
  the cart.
• The first responder needs to get out and open the
  oxygen supply box.
• The practitioner that will intubate should open
  the intubation box

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Mayday Reminders

• Remember the back board-dont do CPR in the bed!
• If you have an AED on your floor, hook up the
  pads ASAP, then turn on the machine.
• Document on the Mayday sheet during the code, not
  after. This will prompt you to remember details
  that you wont remember later.

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Other Emergency Calls-

• Pharmacy Emergency Team-ICU, ED only
• Rapid Response Intubation-ICU, ED only
• Brain Attack Team (BAT)-adult patients only

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MUSC BRAIN ATTACK TEAM
Dial 2-3333 to activate the team BAT will
respond within 15 minutes Responds in the adult
hospital, adult outpatient, adult ED (from onset of symptoms)
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MUSC BRAIN ATTACK TEAM
Why have a Brain Attack Team at MUSC ?
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South Carolinais the buckle of the Stroke Belt

• There is a stroke every 45 seconds and a death
  from stroke every 3 minutes
• Berkeley, Dorchester, Charleston combined have
  more strokes than the entire state!
• Only Arkansas has more strokes than SC nationally

• A male in SC is twice as likely to suffer a
  stroke and 4 times as likely to die from that
  stroke as elsewhere in the United States
• 4 out 5 families are affected by stroke
• We will spend over 60 billion on stroke care in
  the US this year

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The Brain Attack Team includes

• Neuro-Intensivist
• Stroke Neurologist
• Stroke Program Nurse Coordinator or NSICU Charge
  RN

• Support staff also on page
• Neurology House Staff
• Neurosurgery
• Interventional Neuro-Radiology

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Where can the Brain Attack Team go?

• All adult inpatient locations
• All adult outpatient areas on the main campus
• MeduCare will transport all outpatients to the ED
  where the BAT will respond
• MeduCare will also transport inpatients from TCU,
  IOP, CMH to the ED where the BAT will respond

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When to call 2-3333 and request the Brain Attack
Team?

• Call the Brain Attack Team if your patient is
  experiencing any stroke warning sign
• Loss of sensation
• Weakness ( esp. one sided)
• Confusion
• Trouble speaking or understanding
• Dizziness, loss of coordination, balance, trouble
  walking
• Sudden severe HA without known cause
• Any other symptoms suggestive of stroke

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ACTF.A.S.T. for Stroke

• FACE Ask the person to Smile. Does one side
  of the face droop down?
• ARM Ask the person raise both arms. Does one
  arm drift down?
• SPEECH Ask the person to repeat a simple
  sentence. Are the words slurred?
  Can he/she repeat the sentence correctly?
• TIME If the person shows any of these
  symptoms, time is important!
• If in the hospital at MUSC call 2-3333 for
  the Brain Attack Team (BAT)
• If out of the hospital, CALL 911!

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Brain Attack Team Question 1

• Where can the brain attack team go?
• A All adult inpatient locations
• B All adult outpatient areas on the
• main campus
• C Childrens Hospital
• D A B only

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Brain Attack TeamQuestion 2

• The patient must exhibit at least 3 signs of
  stroke before the Brain Attack Team is called.
• A T
• B F

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Brain Attack TeamQuestion 3

• The number to call at MUSC for the
• Brain Attack Team is
• A O for hospital operator
• B 2-2BAT
• C 2-3333
• D 911

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Congratulations!

• You have completed the MayDay and Brain Attack
  Team Module!