Tuesday, January 24, 2006

Code


Adrenaline intensifies the experience. Rather, “Epinephrine”, is the medically correct term.

It’s during a “code”, a word substituted for “cardiac arrest”, which is a descriptive term for the final common pathway for all causes of “death”, that one feels its effects sharply. It’s a funny word if you think about it.

My thoughts race as I run the white corridors. I am responsible for all that reside within the confines of these walls. Looking at them now as they surpass me by, one can’t help but make the heavenly association. My patient slowly drifts towards a white light and I run through it as fast as I can, fighting to save him, back to my white walls, my insane world.

“Attention, attention, attention, cardiac arrest five west”

Five West is the Gynecology floor and quickly I note to myself that they probably don’t know what to do in this situation. Doctors who care mainly for young patients rarely have to perform under the pressure of an arrest. Those more accustomed to this battle should volunteer to help.

So I did. Noting all the while, as I run full speed through the corridors, there is a young woman on the other end. White corridors, she is probably dead now. And I am violating hospital policy. “Slow down doctor, running is not allowed”. Who said rules are made to be broken?

“Epi, atropine, shock” I rehearse…

“Epi, atropine, rhythm” correcting myself. Sweat slowly accumulating on my brow. I need to join a gym. I can’t believe I’m thinking about this right now, distracted.

Chest compressions, intubate, continue chest compressions. I think codes look so great and exciting on television. Do we have a central line yet? Where the hell is Anesthesia?

The crash cart is open, there is blood on the floor, there is some on the bed and also on the doctors, their scrubs and the floor, again, I note. She is intubated and we continue chest compressions. There is some blood on my scrubs as well. Iodine is everywhere. Codes look peaceful on television.

Cardiopulmonary arrest is defined as the abrupt, unexpected cessation of spontaneous and effective ventilation and systemic perfusion (circulation). Cardiopulmonary resuscitation (CPR) provides artificial ventilation and circulation until advanced life support can be provided and spontaneous circulation and ventilation can be restored.

CPR saves lives. Certain states now encourage the purchase of an automated external defibrillator by allowing a tax credit for this purchase. Please take a CPR course so that one day you may help another, and get the word out so that one day, someone may help you.

19 Comments:

Blogger incidental findings said...

Codes are also more successful on television. So far, I've only had one code that I've run result in anything other than death.

Or maybe I need to brush up on ACLS...

3:14 PM  
Blogger Code Blue said...

I was the night charge nurse in an open-heart ICU but had never taken ACLS. When compelled to do so I made a fatal mistake. The next time I went to work I hoped someone would code. Be careful what you ask for. It happened. In private hospitals there aren't usually hot & cold running MD's at a quarter to one in the morning. The only two in house were in the emergency department tied up with emergencies of their own. I ran the code. There is a God. The patient had intractable v tach--the exact algorithm given me in megacode. The patient lived and went home. I was a basket case for two days. That was the only time in my thiry years as a nurse that I was involved in a code that was not run by an MD. The pressure is hard to describe and I had a new-found respect for the guys who do those things on a regular basis.

3:17 PM  
Anonymous Moof said...

Are we going to hear if she made it or not?

.

4:22 PM  
Blogger jeff said...

Indeed - and since it was Gynecology, perhaps there was a baby involved as well?

On that note, I finally got re-carded for CPR and first aid today... first time it's been official since '86. Since then the Army seemed more interested that I know what to do with a sucking chest wound than a heart attack.

4:52 PM  
Anonymous Kel said...

I used to run the things back in the resident days.

Now a days I stand behind the resident running the code and whisper advise into his/her ear like Rasputin to Czar Nicholas II.

The kids have to learn to do these things some how.

5:44 PM  
Blogger AEDhub99 said...

I recently published an article on AEDs – here is a quote from it, in case you are interested:

Statistics give us more and more pieces of information that are bound to worry us, to make us react and change something if we can. More and more people and in earlier and earlier stages of their life die of a heart disease. Statistics, only in the US, are extremely alarming:
- Every 30 seconds someone dies because of a heart disease;
- More than 2.500 Americans die daily because of heart diseases;
- Every 20 seconds there is a person dying from a heart attack;
- Each year 6 million people are hospitalized because of a heart disease;
- The number 1 killer is a heart disease.
Although AEDs are not a universal panacea for all heart diseases, nothing else can compete to its major feature, that of actually re-starting the heart after it has been stopped by a sudden cardiac arrest. Under these circumstances is it necessary to ask you why anyone in this world, any family, in any home would hope for having such a device in their first aid locker?

If you feel this helps, please drop by my website for additional information, such as Public Access Defibrillation PAD or additional resources on AED manufacturers such as Philips defibrillators, Zoll AEDs or Cardiac Science AEDs.

Regards,

Michael

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Anonymous Winstrol said...

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9:41 PM  
Anonymous Anonymous said...

I was the night charge nurse in an open-heart ICU but had never taken ACLS. When compelled to do so I made a fatal mistake. The next time I went to work I hoped someone would code. Be careful what you ask for. It happened. In private hospitals there aren't usually hot & cold running MD's at a quarter to one in the morning. The only two in house were in the emergency department tied up with emergencies of their own. I ran the code. There is a God. The patient had intractable v tach--the exact algorithm given me in megacode. The patient lived and went home. I was a basket case for two days. That was the only time in my thiry years as a nurse that I was involved in a code that was not run by an MD. The pressure is hard to describe and I had a new-found respect for the guys who do those things on a regular basis.

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8:36 PM  
Anonymous Buy cialis said...

in that image, the guy with blue pants is doing a RCP, isn't he? I learned that medical maneuverer when I was in high school and I have saved around three lives

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