Code Blue: Lesson brought to life
It was an ordinary Tuesday for Christinanna Wilkerson when extraordinary circumstances put her nursing reflexes to the test. On Nov. 1, Bernard White, a UF Health Jacksonville psychiatric evaluator, was in the Pavilion of the UF Health Jacksonville campus to complete his Basic Life Support training with Wilkerson, a UF Health Jacksonville clinical education specialist and nurse educator. White had just completed the online portion when Wilkerson noticed he didn’t look well.
“As we were walking back to the conference room for the hands-on portion, he looked a little weak,” Wilkerson said. “When we got to the office, I pulled out a chair and asked him to have a seat. As soon as I pulled out the chair, he collapsed.”
White felt fine all morning, but then his heart began to flutter and he felt a little lightheaded. White remembers Wilkerson pulling a chair out, but that’s all. White fell face first, hitting his head on the conference room table. Wilkerson’s nursing instincts kicked in — she called for help, rolled White over and began compressions.
“Initially I thought, ‘Oh my gosh. This is so surreal,’” Wilkerson said. “I didn’t think he was going to collapse. So at first, I panicked just a little bit, but then immediately the nurse in me kicked in, and I knew I had to do CPR. I went right for his chest and kept doing compressions until help arrived.”
The two were in an office suite, which isn’t a common place for a medical emergency. Luckily, Hannah Pegarido, an administrative assistant, heard Wilkerson’s call for help and was able to bring a crash cart and locate Linda Lawson, the division director of the Pavilion’s nursing services. Lawson called a Code Blue, and staff from all over the hospital rushed to help. A Code Blue signifies that someone in the area is in need of immediate medical attention, most often as the result of respiratory or cardiac arrest.
Nurses from the Pre-Admission Testing and the Transitional Care Unit came to assist, as did members from the Clinical Center. Annette Wall with the Code Blue Team and Caitlyn Borkowski, MD, an emergency medicine resident, raced from across the street to see how they could help.
“Because everyone knew it wasn’t a nursing area, they figured it was someone who worked here,” Wilkerson said. “Everybody was coming to rescue their teammate.”
Once the Code Blue was called and help started to arrive, Candy Parrott, a member of the Rapid Response Team, used the automated external defibrillator to shock White, who immediately woke up.
“I heard someone call my name. I opened my eyes, and it was one of the Emergency Department doctors I work with,” White recalled. “I asked, ‘What are you doing here?’ Then I realized I must have been unconscious.” White has atrial fibrillation, a condition in which an irregular heartbeat causes heart palpitations, shortness of breath and a decrease in exercise tolerance.
This contributed to White’s episode of ventricular fibrillation, or v-fib, a life-threatening cardiac rhythm disturbance where the lower chambers of the heart can’t pump blood, causing cardiac arrest. The only way to revive someone suffering from v-fib is by immediately starting chest compressions and using a defibrillator.
Once White regained consciousness, he was transferred to the emergency department, where he was stabilized and then admitted to the Coronary Care Unit. “I saw a cardiologist, and they did a complete check up on my heart and found no blockages,” White said. “They decided that an internal defibrillator would be the best course of action, and I agreed.”
The physicians at the UF Health Cardiovascular Center implanted a cardioverter-defibrillator underneath White’s clavicle bone. Wilkerson explained that an ICD is put in place so if v-fib happens again, the device will send a shock, restarting his heart. Wilkerson and White are both grateful for the timing of this unfortunate incident. It’s not common for someone to witness cardiac arrest.
“I’ve been a nurse for several years, and I’ve never seen a patient just collapse right in front of me,” Wilkerson said. “So I’m very grateful I was there to assist, and he recovered immediately.”
Overall, it took the Code Blue team about six minutes to arrive. White was transferred to the emergency room within 15 minutes of his cardiac arrest. Wilkerson was thankful for the number of team members who showed up to lend a hand.
“I’m glad that someone was in the suite with me because it was after 4 p.m., and everyone was getting ready to go home. It really was a team effort,” she said.
These days, White is recovering at home. He continues his follow-up care and medication management with Robert Kim, MD, a cardiac electrophysiologist, and hopes to return to work soon. He is incredibly thankful for the care he received at the very hospital where he works and is especially grateful to Wilkerson.
“She did a wonderful job,” he said. “It was excellent.”
White’s experience and quick treatment exemplifies the compassionate care at UF Health Jacksonville.
“I am so very proud of our team members,” said Deborah Maxwell-Hodges, ARNP, who also assisted with the emergency. “Each of our team members went into the Code Blue and contributed without hesitation, in a professional manner with skills and knowledge, and went to work where they identified needs.”