Code brown

[HeadNurseRN]

It's funny to say sometimes "Code Brown" if you don't know what I am talking about you must :censored::censored::censored::censored: out ice cream. Seriously, I know BLS trucks carry bedpans and stuff like that but I heard two things if someone were to "Code Brown" in the truck. A paramedic told me to clean them up if there going to a rehab center or nursing home especially if there on hospice. Now an EMT told me there going to sit in it for the ride and to do nothing. I am just curious on what the right thing to do. I've worked in nursing homes with the elderly and when it happens I always help the aide right after I lock my med cart. The point is thats someones father or mother or uncle and I wouldnt want my family member to just sit in it. What is the right thing to do????

 

[emt-mike]

I probably wouldn't clean it.
not because I want someone sitting in their own poo,
but because there are generally bigger issues to take care of.

 

[firetender]

It's YOUR choice

who are you? Are you a person who gets satisfaction out of being supportive of someone who can't take care of themselves; symbolically cleaning the muck off a child's face. Is that who you are?

Or are you having a hard time finding the chapter about asswiping in your protocols?

You might even ask yourself is this particular person someone who's butt you want to polish?

Honestly, it's a :censored::censored::censored::censored:t y decision you have to make, but I would hope it would be based on the particular situation and patient rather than what anyone here says is THEIR way.

Find your own way, but asking for other perspectives is good as well!

Enjoy the time you've been given, even if your only tool is a washcloth!

 

[EMTGunney]

dont do it

i have had a couple code browns and there isnt enough room in the back of an ambulance to do that in my opinion, and it is not critical to pt care

 

[MMiz]

Good 'ole code brown. There just wasn't enough room in my van on the Stryker to do much to address the issue. I've helped the NH address it when there, but there isn't much I can do when the patient is secured to the cot.

 

[Smash]

There's nothing sexy about cleaning up feces, but it's even less sexy to die of sepsis from your infected decubitus ulcer either. I was of the understanding that we are here to help people. I wasn't aware that such help only involved sticking needles or tubes in them. Perhaps I was wrong.

I'm just curious what it is that is critical to stop the patient dieing that is going on during interfacility transport, to such a point where basic and necessary patient care is ignored?

 

[HeadNurseRN]

I read all these replies while laughing my *** off! Ha! I was just curious some people read waaaaay into this :censored::censored::censored::censored:, no bum intened. Ever disimpacted someone? That's fun! Thanks guys!!!!!

 

[MrBrown]

*Brown sprints up in Browns now-shelved orange "DOCTOR" HEMS jumpsuit with Thomas pack slung over Browns shoulder and Lifepak in hand ....

Yes hello Dr Brown here, helicopter emergency medical service, you called?

 

[bigbaldguy]

It's just poo, everybody poos wipe it off clean it up and never speak of it again.

 

[b2dragun]

I am 5 minutes from wherever I am dropping off...turn the exhaust fan on and open a window. I am not cleaning anyone up, unless it is a dirty wound I don't clean. If I worried about cleanliness then I would spend all my time cleaning, you have no idea how many of my pt's piss or code brown themselves. The homeless I run on have weeks worth, the drunks have plenty too. If it is a transfer then a couple minutes of being in feces won't kill them, chances are they lay in it for longer while at the facility anyways. When in doubt I am more then willing to refer to my EMT-B and EMT-I books that do not make mention of this.

 

[MasterIntubator]

This brings back many many memories of having to deal with the fruits of the gastrointestinal system. Having to deal with the digestive leftovers is not enjoyable, and if you are weak... you are weak. You will vomit with the best of us.
Many moons ago, I show up on a scene in an apartment complex, the BLS crew is standing outside the door, the fire guys are gladly leading us up to the second floor.... before I get a chance to get in the door, one of the EMTs advise me that they believe that the person is not hurt, and that it was definitely an ALS call.
Well..... I turn the corner and sure enough, there was an elderly person lying on the floor with the ensure blues. Mudbutt trails leading from the hallway to the phone in the living room. It clicked.... those BLS :censored::censored::censored::censored::censored::censored::censored:s. My crew and I look down from the breezeway.. the BLS crew and fire guys on their way to the rigs... "Forcible entry done... bye".
I say "Thanks" loudly as I wave 'bye' with my middle finger..... they are gonna get theirs..... ( and they did that night..... as a few of my cardinal rules of EMS include don't funk with the ALS crews.... another is don't jump a call out of your due, you may regret it ).... they got theirs... ehh ehh - nother story. We all come from the same station anyway, attitudes channel thru midnight revenge in the bunks with fun and learning... )
Needless to say, we cleaned this guy up.... and transported him without further issue. No doubt he was embarrassed and ashamed of his situation, and there is no worse feeling when you are all alone, and have a bubble-gutz situation that blevied from the crack, and no one will help. Just imagine medical pros standing around with that disgust look on your faces.... just staring.... not moving, no action... the silence in the air as that sick person ( who is fully alert ) is begging for help silently....

I'm not gonna sit there.... some folks have made their minds up outside the door not to cross that threshold. That there separates the weak from the strong. This scenario is acceptable and well within our training and scope.... but we do have our down days.... someone has to do it.

( p.s. It gets easier if you do happen to hurl..... whatever you do... don't try to swallow your puke back down.... it will backfire ) no pun intended

 

[VFlutter]

I am 5 minutes from wherever I am dropping off...turn the exhaust fan on and open a window. I am not cleaning anyone up, unless it is a dirty wound I don't clean. If I worried about cleanliness then I would spend all my time cleaning, you have no idea how many of my pt's piss or code brown themselves. The homeless I run on have weeks worth, the drunks have plenty too. If it is a transfer then a couple minutes of being in feces won't kill them, chances are they lay in it for longer while at the facility anyways. When in doubt I am more then willing to refer to my EMT-B and EMT-I books that do not make mention of this.

Wow. So just because the nursing home or facility does not do their job properly or neglects their patients that gives you the right to do the same? That is so great logic. Maybe i am just naive but the core concept of our profession is to be a patient advocate. Sounds like you are doing a fantastic job. Also what makes a homeless or drunk person different? We should treat all patients with the same respect regardless of any other factor. Again maybe i am just being over sensitive but seriously what has happened to compassion for patients.

 

[emt-mike]

I don't know about yours, but our ambulances don't have bathtubs in the back.

 

[reaper]

These threads always bring the cream to the top. Shows which providers need to be run out of EMS and fast.

If you do not want to do the job, then leave. There are plenty more behind you that would be happy to help their fellow man.

 

[VFlutter]

I don't know about yours, but our ambulances don't have bathtubs in the back.

It is one thing to state that you do not have the adequate space to perform the task, which i can understand. But you can still have the decency to use more appropriate language and not just say "Oh well they can just sit in it if they code brown"

 

[Smash]

I am 5 minutes from wherever I am dropping off...turn the exhaust fan on and open a window. I am not cleaning anyone up, unless it is a dirty wound I don't clean. If I worried about cleanliness then I would spend all my time cleaning, you have no idea how many of my pt's piss or code brown themselves. The homeless I run on have weeks worth, the drunks have plenty too. If it is a transfer then a couple minutes of being in feces won't kill them, chances are they lay in it for longer while at the facility anyways. When in doubt I am more then willing to refer to my EMT-B and EMT-I books that do not make mention of this.

Hmmm... and still people complain that American EMTs don't get the respect or money that they deserve.
I would present this as evidence that for the most part, they get exactly what they deserve.

 

[emt-mike]

I never said that I would let them sit in their own poo, I'm just saying I'd let somebody better equiped (i.e. a nursing home/hospital/whatever) handle the situation, instead of using chux and 4X4's to try and clean up a whole dirty stinky mess.

 

[fast65]

I am 5 minutes from wherever I am dropping off...turn the exhaust fan on and open a window. I am not cleaning anyone up, unless it is a dirty wound I don't clean. If I worried about cleanliness then I would spend all my time cleaning, you have no idea how many of my pt's piss or code brown themselves. The homeless I run on have weeks worth, the drunks have plenty too. If it is a transfer then a couple minutes of being in feces won't kill them, chances are they lay in it for longer while at the facility anyways. When in doubt I am more then willing to refer to my EMT-B and EMT-I books that do not make mention of this.

Hmmmm, I must have been sick the day when they mentioned that cleaning up a patient was below us. Weird.

I understand that it might be difficult because of the lack of space, and I certainly understand that it isn't the most pleasant part of the job, but it's just that, part of the job; if you can't deal with it, then you might want to choose a different career.

 

[adamjh3]

Do any of us want to spend time cleaning the microwave at station? Vaccuming the floors? Cleaning the bathroom where it seems like your co-workers pee everywhere but the toilet? Nope. But it's part of the job. I think y'all know where I'm going with this.

If it's a code or there's some form of life threatening issue, no, I'm not going to spend my time wiping someone's bum-bum with some 4x4's.

Our Tx's are usually pretty short, so I'll often wait until we're at the facility so there are more appropriate tools and adequate space and help the staff at the facility clean up. But I'm not just going to dump the pt off, get my signature and bail out of there like nothing happened.

 

[Akulahawk]

I just take a practical approach....

Whether or not I attempt to clean the poo off the person while I'm in the back depends upon how far I'm from the destination. If I'm on scene, I'll try to assist the person attend to the porcelain goddess or clean them up prior to transport, if there's time. If it's going to be a while in transport, I'll do my best to clean 'em up. If the arrival time is short, I'll just bring 'em inside, let the staff know so they can get the stuff necessary and I'll help clean 'em up then.

If the person KNOWS they've got to go... while in transport, I'll dig out the bedpan and get things prepared (hopefully) before the bowels burst. There really isn't a LOT of room in the back and if the patient has VERY liquid poo that is released under pressure... well, I'd rather contain rather than let the patient's poo spray all over, and then clean up.

Sorry if that give anyone a rather Code Brown visual...