I'm sure that many of you remember hearing that report of research that showed that on TV, the code blue save rate is something like 90%, but in real life it is much lower than that. TV contributes to a misapprehension that the Code Blue is a universally successful procedure.
Now, the Code Blue procedure was primarily developed to resuscitate dysrhythmia in the setting of acute myocardial ischemia. As most cardiac nurses know, when you do a code blue on a patient like this promptly in the ICU (or the field), the procedure works well. It doesn't work as well when their are complicating factors such as congestive heart failure, multiple system failure, infection, and just being old.
Here's my thesis: I feel that all too often coding is proffered as a solution to a problem that it is actually poorly suited to and unlikely to solve. Coding is actually unlikely to solve cardiac arrest in multiple system failure, old age; tired, multiply infarcted hearts, etc. (And I think research could be done to support this contention based on retrospective research.)
Anyhow, do you think the general public needs to be more aware of this? people, I'm not saying "never" code an old person BUT if families were aware that a code procedure was unlikely to successful and was more likely to de-humanize people in their last moments of life, don't you think they could do more realistic planning and decision-making?
I'm a big believer in CARE not CURE approach for MANY of the souls we see repeatedly in the hospital. Thoughts?
