COR Zero

                                                               (Torsades de Point)

I'm a cardiac nurse. 

I've always known of the responsibility it holds but never before have I been more proud to own the name and know it is a title of honor. Yesterday we had a COR Zero, or what you might call a Code Blue, terms used to say someone's heart stopped beating. I've responded to tons of STAT calls, but never been involved in a true COR.

We were no more than minutes on the floor. It was around 6:58 or so and I was waiting for report on my patients when the telemetry tech yelled out, V-TACH and the room number!! That means RUN to the room!

When we got to the room, we found the patient down on the floor. Another nurse and myself lifted her to her bed and called the COR over the paging system.  Next thing I know there is a Cardiac Surgeon at might right asking for me to find a pulse (what luck we had to have him on the floor at that exact moment).  I couldn't find a pulse anywhere. Neither could he or one other nurse. 

The crash cart was in the room, we hooked her up to the monitor.  She was truly in V-tach!  The doctor started compressions, the bag mask was applied and another the nurse was giving respirations.  I looked up and there were at least 20 people in the room.  This was a true COR zero.

We gave all the right drugs. Amiodarone at one point, Epinephrine at another.  

CLEAR........... and she receives a shock.   A pulse, but bradycardia.  Now Atropine.....she goes back into V-tach.  Another shock......more drugs, a pulse, too slow, a shock.

We ended up shocking her four times!!!

When her heart rate was finally stable enough we sent her to ICU on a heart drip.

We've had a lot of STAT team calls which require all the same people but the patient has a pulse. (By the time the STAT or COR has been called there are representatives from our cardiac floor, respiratory, pharmacy, ICU, life flight, the doctor, sometimes someone from ER, so there ends up to be A LOT of people in the room.  *Sometimes too many*)  They might not be conscious, but they have a pulse....that's the requirement for a STAT over a COR Zero.  Lately I've been very on my game because of a Mock COR we had the other day.  

I feel it paid off.

Later, when we were doing all the final paperwork (I got in on that part because I charged the floor for the day) viewing the telemetry strips showed the patient went into the rhythm Torsades de Point at the beginning of the COR.  This is the most deadly rhythm because the heart is totally out of wack and not beating in any kind of productive rhythm at all.  That is the first time I ever saw a true Torsades let alone responded to it.

We later found out this woman had a massive heart attack.  What luck, to have a heart attack on a telemetry floor!

Later, my manager said she got a compliment from one of the hospital nurse practitioners saying she was impressed at how I jumped right in to assist. She also said this particular nurse doesn't hand out compliments! 

That made me proud!  

It was truly an amazing thing to be a part of and that was why I joined the Cardiac team in the first place.