Broken bones

I've never broken another person's bones before. 

Last night, the words, "I need a nurse in room 15 NOW" rang out from the monitor station on our unit, breaking the early morning stillness.  I ran into the room (somehow donning gloves on the way) and found an older gentleman lying in bed, staring at the ceiling blankly, and his chest wasn't moving.  I checked his pulse.  Nothing.  I checked his arm for a DNR bracelet, called out for someone to call a code. 

One of our nurse's aides ran in and, exhibiting superhuman strength for a woman her size, rolled him to the side so we could place the board underneath him.  At the same time another nurse came in with the code cart, saying he was in asystole (for non-medical folk, this is the "flat line" you see on TV... not good).  We got the board placed and lowered the bed as far as it would go... which was unfortunately not far enough for a woman of 5'6" to give effective compressions to a large, barrel-chested man.  I climbed onto the bed, kneeling next to his chest, and began giving deep, forceful compressions. 

The code team arrived within a minute, and as the respiratory therapist struggled for 12 whole minutes to get a breathing tube placed, as the monitor on the Zoll defibrillator continued to show no rhythm, as IVs were started and drugs were pushed, I kept pressing with all of my might into that man's sternum.  I felt sweat running down my face and gathering behind my knees.  I felt something crack beneath my hands, and was vaguely aware of the fact that I probably just broke one of his ribs.  I heard the physician's voice say, "hold compressions".  I pressed my fingers against his neck, and said "I've got a pulse".  A glance at the monitor showed P-waves and QRS complexes.  A nurse on the other side of the bed reported a BP of 225/120... not great under normal circumstances, but it was something.  I climbed down from the bed as they prepared to wheel him down to intensive care. 

The likeliness of him recovering is slim, having been without an airway for as long as he had been.  But every person in that room was fighting as hard as they could to give him a chance, and I have the sore back to prove it.  I just hope that if he does recover he gets adequate pain management for that fractured rib.