Saturday, September 6, 2008

Tough Code

I don't know if this makes me seem callous, but I'm usually able to remain pretty well detached during codes.  Last week, however, we had one that got to me.  Maybe it was watching the attending cry afterwards, maybe it was the exhaustion that came from keeping up compressions, but this one was tough.

Walked into work the other night, and as I was waiting to punch in I helped transfer a patient onto a stretcher as she made her way back from the waiting room.  A few minutes later, I was stocking supplies at the beginning of my shift when someone grabbed me and said they needed an extra set of hands for a code.  I ran over and joined 15 people crowded around the woman I had just brought in: middle-aged female who came in complaining of shortness of breath.  She had been anxious and yelling only a few minutes ago, but now was unable to maintain a pulse without compressions.  Fluid bags were squeezed in, a central line started, transcutaeous pacing and an A-line attempted. Cycling through rounds of compressions with a few other techs, I had sweat running down my forehead and my arms were exhausted.  We were at it for over an hour.

Most times a code comes in arresting after a major trauma, or is sick and elderly, or has already been down for an extended period of time.  Most times I don't get to see the person walk in, help them on a stretcher or listen to them talk before I'm pounding on their chest with their lifeless eyes staring back up at me.  This was the first time I had someone walk in, code, and die in front of me.  As I stuck around afterwards to help clean up the body, I overheard that she had a history of cardiac problems, but had stopped taking certain meds while trying to get pregnant, and that's when it hit me.  I had tried to remain detached, but by that point it really hit me.  

After taking a few minutes to decompress, I got back to work.  Thankfully, there were very few patients for the rest of the night, and everything remained quiet.

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