My first code

I recently ran my first code. I thought it would be horrible, but in actuality, it wasn't that bad. Of course, initially, it was miserable. I was ready to wet myself. However, after the first 5 minutes and the patient hadn't turned around, I realized something somewhat profound. This person, if I stopped right then and there, was dead. The only thing keeping the patient from being dead dead was the nurse pumping his chest and another bagging his lungs.

The thing about ICU that one of my attendings impressed on me is that you can't save everyone. Heck, you can't even save most. You do what you can with the tools given to you, and let God do the rest. The thing about the unit is that the only patients that get to the unit are ones that are dying. And if you're not dying, then you don't deserve the unit bed.

I feel better about codes now, and I've got a few under my belt. The shock of watching someone die, it goes away after a while. You do what you can with the tools you have.


Anonymous said...

I wonder sometimes if we are doing a disservice to people by "bringing them back" after 30 minutes of coding without a pulse / blood pressure compatible with life. I've had a couple that regained a pulse 30 minutes into it, and you know that they're cooked and will be discharged to a chronic vent facility on a trach nowhere near their former self.

incidental findings said...

I think it's reasonable to call all codes greater than 20 minutes. I've yet to see someone get past 5 minutes of coding and have an outcome other than death or severe anoxic brain injury.