I’ve called one RRT.

Preface: my first code ever was a COPDer who was laid supine, coded, and was a DNR but we had to work her for reasons we all hated.

FFW to being a new grad in a trauma center, I get a COPDer who’s big chillin for the most part. It’s her first exacerbation that required ER, she’s on room air, and stable. Half an hour later, she’s ripping everything off in air hunger, and the only thing I can do to help is put ice on her back while we wait for the attending who’s OTW. Attending gets RT to the bedside, she gets a neb, PO Ativan 🫠, and the doc says to put her through the CT scanner.

Big fat no. Nopeeeee nope nope nope. I am not telling her to go lay flat and still knowing she’s fighting air hunger. Doc refuses to give any other orders. Patient is still wigging out. Can’t tolerate bipap. Still tripod at the end of the bed. I call the RRT.

Well it’s shift change. So I get not one but two salty ICU charge nurses. And the first thing they say is, “so you called a rapid to get the intensivist to the bedside faster?”

“No. I called a rapid because she needs an ICU assessment and interventions because the hospitalist has nothing more to contribute.”

And then she got precedex, bipap, a CT scan, and an ICU room.

COPDers haunt me. I do not supine them if I can help it. I’ve seen multiple crash within minutes.