Medicalese 101: Code Blue: What is a code really like?
What are codes? - anon
Every hospital has “codes” that they will call over an intercom to alert employees to an emergency situation. For example, at my hospital, code red is fire, pink is a stolen baby, green is hazardous materials exposure, and gray is “code act a fool,” alerting security to come take care of some belligerent family members ;).
The designations vary from hospital to hospital, but almost universally a “code blue” stands for cardiac / respiratory arrest. The code blue is the most commonly called code, and thus often is shortened to just “a code”. When we say that a patient coded, this is what we mean.
Real life codes are WAY different than on tv.
When a patient is found in cardiac arrest, the first responder immediately starts chest compressions and calls for help. A team will come into the patient’s room with a crash cart containing various medications, a defibrillator, intubation supplies, and a heart monitor. While chest compressions are being done, someone else will assess the patient’s airway and likely will start giving breaths by a bag.
You’ve seen this all on tv. What you don’t experience on tv is the simultaneously squishing and grinding sound of ribs cracking and rubbing against each other when CPR is done properly. They tend to gloss over the eternity that is the 2 minutes of chest compressions between every pulse check and epinephrine administration. You don’t experience the unmistakable smell of stomach contents as the patient vomits involuntarily and aspirates on their own gastric juices. They clean up codes on tv. They don’t want you to see a patient’s head flopping around with eyes rolled back or a nurse jam his hand into a patient’s crotch to try to find a central pulse.
On tv they show you two shocks (even in asystole, when you’re not supposed to shock) and the patient miraculously recovers with full brain function. They don’t show a chaplain explaining to family members that the patient has died and the team is trying to bring them back. And they certainly don’t show the transfer to ICU, the intubating, the starting of pressors, or the eventual exam to declare someone brain dead.
You see, only 11-35% of people who have cardiac arrest IN the hospital survive to discharge, and only 6-17% survive with good neurologic function (reported by he National Registry of Cardiopulmonary Resuscitation). So yeah, we can bring people back. Sometimes. But most of the time their brains are gorked. Codes are violent, messy, and often unsuccessful. They do occasionally save lives, but when it comes to me, hey, don’t code me bro.
It was their third time coding today. Each time they were brought back weaker than before and a little more brain damaged. The family was watching the action through the ICU room window and refused to let us stop.
Y'all, let this be a public service announcement. Breaking your loved one’s ribs, pumping them full of medical grade speed, and shoving tubes down their throat is not necessarily the most loving thing you can do for them. Most of the codes I go to are prolonging suffering rather than prolonging meaningful life.
I’ve said it once and I’ll say it a thousand times: if I’m already in terrible shape or am terminally ill, don’t code me bro. No PEG tube, no ventilator, no compressions, no shocks. Don’t do it. Let me go.
“As I thought, this place is amazing. Interesting cases come one after another. One years experience in a normal hospital… If you’re a flight doctor you can have it in a single month. It’s the same for you, too, right? You came here for that, right? I’ll do it. Right here, I’ll get on the helicopter another time and handle many more cases. And then faster than anyone else… I’ll become a famous doctor.”
I like Toda Erika in Liar Game however the rating is not high at all to reach her top 10 even though I think she got famous from being Nao-chan and also SPEC is another popular one of hers but it had low rating. I wonder why it became so successful and famous.