It Happened To Me TwiceI work in a field where this sort of thing sometimes happens. The first time was a man with emphysema, who had compensated as far as he could and then just suddenly went downhill in the space of a few hours. I was in his room, and I saw him turn the corner from being able to compensate to no longer able to get enough oxygen. I tried all the interventions, and nothing was working, He was a no code (didn't want to go to the hospital or be resuscitated when it was time for him to go) so I sat with him and talked to him, and helped calm his fears and anxiety, and I got his wife on the phone and let him talk to her a little (she was far away and couldn't be with him) and eventually I came into his room and sat down with him and held his hand and laid my other hand on his forehead. He opened his eyes and smiled at me and then he stopped breathing and was gone. Rather peaceful, really.
The second was a bit younger, and not as ill. He was just in the facility to do some rehab after surgery, and was expected to go home in a month or so. He'd been fussy all evening, calling for the nurse and wanting water or a pillow adjusted or something like that. I sat and talked to him for awhile, and it seemed to help, but I had charting to do.
The aide came and got me a little while later... he was having trouble breathing all of a sudden. He was a little red in the face when I got there, and seemed to be in a little distress though he wasn't wheezing. I checked his oxygen level... seemed ok, at 92%. I adjusted him to a little more upright position in bed, and made sure he had the call bell and said I'd be back in a few minutes to check on him. I was back in 10 minutes and he looked a little worse: pale, oxygen down to 89%, heart beat a little raised, kinda clammy and damp. I got a nebulizer out and loaded up a breathing treatment - albuterol for fast relief and Ipratroprium for long acting action. I turned back to him and he had gotten worse in just that minute, I put the mask on his face and started the machine and told him to breath in the vapor, and he started to do that when his eyes rolled up in his head and he slumped in my arms. I had checked his code status before I came in this last time, just to be safe, and he was a no code. I laid him down and ran to get an oxygen tank and tubing, attached it and used the same mask for the oxygen, but it was no good. I was holding him with my arm under his shoulders and the mask on his face when he stopped breathing and his pulse was gone moments later. It had all happened bewilderingly fast. I thought at the time that it was probably a blood clot lodged in the artery between the heart and the lungs, but I'll never know for sure.