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Codes for the Holidays



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Dec 23, 2005 01:52 PM

Codes for the Holidays


'Twas the night before Christmas and in SICU
All the patients were stirring, the nurses were, too.
Some Levophed hung from an IMED with care
In hopes that a blood pressure soon would be there.
One patient was resting all snug in his bed
While visions- from Versed- danced in his head.
I, in my scrubs, with flowsheet in hand,
Had just settled down to chart the care plan.
Then from room 17 there arose such a clatter
We strang from the station to see what was the matter.
Away to the bedside we flew like a flash,
Saved the man from falling, with restraints from the stash.
"Do you know where you are?" one nurse asked while tying;
"Of course! I'm in France in a jail, and I'm dying!"
Then what to my wondering eyes should appear?
But a heart rate of 50, the alarm in my ear.
The patient's face paled, his skin became slick
And he said in a moment, "I'm going to be sick!"
Someone found the Inapsine and injected a port,
Then ran for a basin, as if it were sport.
His heart rhythm quieted back to a sinus,
We soothed him and calmed him with old-fashioned kindness.
And then in a twinkling we hear from room 11
First a plea for assistance, then a swearing to heaven.
As I drew in my breath and was turning around,
Through the unit I hurried to respond to the sound.
"This one's having chest pain," the nurse said and then
She gave her some nitro, then morphine and when
She showed no relief from IV analgesia
Her breathing was failing: time to call anesthesia.
"Page Dr. Wilson, or May, or Banoub!
Get Dr. Epperson! She ought to be tubed!"
While the unit clerk paged them, the monitor showed
V-tach and low pressure with no pulse: "Call a code!"
More rapid than eagles, the code team they came.
The leader took charge and he called drugs by name:
"Now epi! Now lido! Some bicarb and mag!
You shock and you chart it! You push med! You bag!"
And so to the crash cart, the nurses we flew
With a handful of meds, and some dopamine, too!
From the head of the bed, the doc gave his call:
"Resume CPR!" So we worked one and all.
Then Doc said no more, but went straight to his work,
Intubated the patient, then turned with a jerk.
While placing his fingers aside of her nose,
And giving a nod, hooked the vent to the hose.
The team placed an art-line and right triple-lumen,
And when they were through, she scarcely looked human:
When the patient was stable, the doc gave a whistle.
A progress note added as he wrote his epistle.
But I heard him exclaim as he strode out of sight,
"Merry Christmas to all! But no more codes for tonight!"
Jamie L. Beeley


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