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Joint Commission Mandates Extensive Timeout Prior to Initiating CPR

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Joint Commission Mandates Extensive Timeout Prior to Initiating CPR

SAN ANTONIO, TX –  Citing the shocking incidence of “never event” wrong-sided CPR (commonly known as WroSC), the Joint Commission issued new guidelines today mandating a 42-step timeout prior to the initiation of CPR for in-hospital cardiac arrest.

"Where is the ferret?"
“Where is the ferret?”

The timeout can only be initiated by the patient’s bedside RN, period.  When asked if they thought it would be a problem since many times the bedside RN may be unavailable, the Joint Commission spokesperson Beatrice Belarus said, “Absolutely not.  Our policies are 100% guaranteed to keep patients safe.”

Once initiated by the bedside RN, the timeout requires the presence of the charge nurse, the nurse educator, the nurse manager, the chief nursing officer, the patient’s next of kin, the next of kin’s next of kin, and either a licensed physician, a random person from the cafeteria, or a ferret to be a witness.

Chest compressions cannot begin, nor can any defibrillation device be attached to the patient, until all 42 steps have been completed and each step has been independently verified by each RN in the room as well as an RN from another floor with no knowledge of the current situation.  If the patient has had orthopedic surgery in the past year, a Striker rep is also required to verify the completion of the timeout.

When asked if this new policy was evidence-based, spokesperson Belarus laughed and said, “At the Joint Commission we’ve moved far beyond evidence.  We have a panel of expert lay people, all of whom have absolutely no training in clinical medicine, or even medicine of any kind for that matter, who give the full backing of their opinions to our policies.”

Belarus cited the “tragic example” of a recent case at world-famous Mons Hopkins Medical Center in which a code was called for a patient who was found in bed, unresponsive to soft voice call.  The code team arrived and eager intern Abe Moskowitz began “chest compressions” only to learn later that he had been compressing the patient’s back, i.e. “back compressions.”

The patient, who had been asleep, said, “I didn’t realize how dangerous it could be to be a belly sleeper.  But honestly, once I got over the shock of 40 people in the room it was one of the best massages I’ve ever had.”

When asked about what happened Moskowitz responded, “Come on, cut me a break, I haven’t had anatomy lab for 4 years.  Besides, who has time for backs and fronts?  I’m a doctor, man!  I was in the zone, the Code Blue zone!”

Nurse Mary Labrenahan, who had been on break during the code, returned later and had this to say, “That idiot Moskowitz can’t tell his own front from his back.  I’m not surprised at all to hear he committed a WroSC.”

Joint Commission spokesperson Belarus explained that it was “never events” like this that led to the recent new regulation.  “If our timeout procedure had been in place, that nice patient never would of had a surprise wake up with back compressions.”

Mons Hopkins initially resisted the new timeout procedure, citing the importance of rapid initiation of chest compressions in patient survival.  But the Joint Commission threatened to withdraw certification and Hopkins quickly backed off and embraced the new regulation.

Floor to ceiling posters with the 42 steps have been posted in every room in Mons Hopkins Medical Center and physicians are now required to wear the steps on a full-body sign around their necks.

45 COMMENTS

  1. This has got to be a joke! Somebody who knows where this came from, please rescue the rest of us from this conversation.

  2. I’m concerned about this new program. There is no allowance for night shift when a licensed physician is unavailable, the cafeteria is closed… and have you ever tried to obtain a ferret at 3am? It’s next to impossible! ;)

  3. Excellent. Once implemented, I’ll bet ICU transfers from the floor
    PLUMMET. Probably also improve ICU survival numbers. I for one support this
    bold initiative!

  4. This would be funny if something like having a time-out to check DNR status would have been used when my dad arrested, was a DNR, and was resuscitated only to suffer an agonizing 9 days with an aspiration pneumonia before we demanded palliative care. I get the story. I do. But in all seriousness, bedside caregivers should have had that info readily available-even if they had to take a few seconds to confirm- so my Dad didn’t get extubated and ask me “Why did you let them do that to me?”

  5. I wanted to go to Mons Hopkins but I was given to much lip service. I think this began with the Bush administration.

  6. The answer is to dump the Joint Commission…DMV have been much more practical and flexible. The Joint Commission is in business to keep the Joint Commission in business.
    The Joint Commission’s principal benefit to society is that it keeps sub-par practitioners from coming in contact with warm patients while they act as reviewers.

  7. Doesn’t unconsciousness imply consent to treat?

    I was in orchestra rehearsal last semester when a member of the chorus passed out. There were a handful of us there with medical training, so we attended to as best we could until help arrived. Someone else went to call 911 and they were told to hang up because they had to call campus security first and they had to assess the situation first. Turns out the person just passed out, but if she did go into cardiac arrest, those of us with medical training would’ve been of more use than campus security (which, as they stated, have no real medical training, though you’d think they’d at least need a CPR card).

  8. Funny piece but this is the way American society is going because of litigations. I was recently in Universal Studies when I witnessed a woman drop to the floor in front of me. Being the only one around with training in ACLS, I quickly evaluated her and thankfully, she had just passed out and needed some blood to her head. A security guard came over and said to back away from her until their paramedics came…..she could have been in cardiac arrest for all the security guard knew. Welcome to America…..we would rather let people die than get sued.

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