[queenjean]

Our hospital is the same; we follow ACLS with or without a doc's presence. Our ER docs bust their butt to get up to the code immediately; but if they are running a code in the ER along with a couple other very critical pts, they can't always run up immediately and run the code on the floor. Any doc on the floor will respond until the ER doc gets there (that's not always helpful, frankly, but I appreciate the sentiment); but in the middle of the night there just aren't the docs around. I'm not going to sit there with my thumb up my butt, waiting for a medical doc to get there to order the meds.

Our facility has standing orders for meds and procedures in the event of a code blue, and we also have standing orders for certain meds and procedures with our rapid response team--labs, xrays, ekgs, head or chest CTs--it's great. No more having to watch someone deteriorate to a code while you are desperately trying to get a doc on the phone because you know the dude is having an MI or throwing a PE or stroking out. We can initiate a lot of the care (IN THE PRESENCE OF A RAPID RESPONSE TEAM--no, we can't just do it on a whim) when some decides to go south in a hurry. Our code teams and the rapid response team differs really only by the presence of a doc--the ER doc isn't required to come up for the rapid response call, but they often do.

[Cat84]

we also are allowed to start acls protocol. We also have an emergency management standing order set that includes fluid boluses, dopamine, o2, ekg, etc. and we would be punished for not starting these things. (i work in cc) CAT

[Babs0512]

Generally speaking, I believe that's it's true, the MD's order the drugs, HOWEVER, in our hospital, if you are ACLS certified, (as I am) I can run a code without an MD, or rather until the MD gets there.

I have run many codes, someone has to call the shots and keep things orderly, since most people shy away from that, I would usually step up to the plate. I would never deviate from ACLS protocol though.

I'm always very happy to give up running the code when the MD arrives.

[owensmommy]

At my hospital, you can also initiate ACLS protocol (CPR, defibrillation, meds, etc) as long as you are certified. An ER doc is responsible for coming to all floor codes and they usually show up pretty quickly. They take over the code when they arrive. Things usually go pretty smoothly.