Code Blue Experiences

ImThatGuy, BSN, RN · Jan 25, 2011

My first was found down in his front yard. Presumed heart attack. Resuscitation attempted. Man was dead.

Past that they all kind of run together.

RescueNinja · Jan 25, 2011

I have been to many codes none of which were successful.

One was a youngish man in his 50s and I don't know what his dx were but he did have COPD. He was calling for help and I went into his room during one of my first clinical shifts ever as a student and had no idea WTH to do so I called for a nurse and then called the code.

One was an older lady 70-80s who was "full of Ca" and had a bowel obstruction as well as many other issues. At the start of the shift her daughters had been in and she was awake and talking to them, but by 0800 her nurse had found her slumped over and cold. There was feces & vomit going everywhere. It was awful. The worst part is that we were waiting for the POA to come and sign the DNR form that morning.

Another was a lady in her 60s I believe that the floor had called and asked us (ICU) to come and assess to give suggestions because she was going downhill fast and they couldn't reach the doc for an order to transfer to the unit. We finally got her in the unit and she was begging us to help her breathe. We didn't even have her leads on (first thing we do) before her eyes were rolling and she was purple. We started the code and it lasted the longest of any code I've ever been to, but unfortunately pt died.

Etc etc etc...

I have never had to go to a peds code (thank God) and hope that is something I never experience.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 25, 2011

Remember, everybody dies eventually, so in a code you're working against the odds. 30 years in health care and I doubt I've ever seen 2 codes alike except that something always goes wrong. I judge the teams success by how well they handle what goes wrong, the unexpected. It might be expired meds, cracked suction canister, dead batteries in a portable monitor (I remember being excited when the Lifepack 3 came out! Now they're up in the Lifepack 20's!)(and no, the Lifepack 3 wasn't coal powered. That was the Lifepack 2).

The patients? Some died that shouldn't have for no apparent reason. Some Lived and had productive years. This is more and more common. The ones that make me so mad I want to spit were the ones with terminal illness but accepting families. We'd do everything at the families insistence, get them back, then they'd have to die again later. Get them back. Die again. Get them Back, die again. Longest I ever counted was someone who died 7 times in one shift, and continued the same on the next shift. Brain cancer wasn't cruel enough, the family made us keep making him die over and over, until the family finally were exhausted and we were allowed to allow a normal human process take place.

Sorry, you touched a nerve. Guess how many ER nurses get DNR or NO CODE tattooed on their chests! :crying2:

shoegalRN, RN · Jan 25, 2011

One of the best codes I've ever seen:

Guy in mid 60s brought in by EMS, in complete cardiac arrest. No pulse, no BP, not breathing, asystole, NOTHING.

We worked and worked on him, got him tubed, chest compressions, pushing every drug in the crash cart, and then the guy goes into V-fib. We shock him and start back with compressions. He goes back into V-fib and after 45 minutes of compressions, the guy starts moving, raising up off the stretcher, good color change, and starts trying to fight, all while in V-FIB! It took 4 people to hold him down! We finally get him to NSR and transfer him out since we don't have a CVICU. The guy makes it and was in the CVICU of another hospital in town. Don't know if he ever made it out of the CVICU.

We worked on that guy for 2 hours at the least.

**NickiLaughs, ADN, BSN, RN** · Jan 25, 2011

We had a guy who woke up out of the code (was a physician) and wanted an update on his status and started barking orders.

Nurse0621 · Jan 25, 2011

We had a guy who woke up out of the code (was a physician) and wanted an update on his status and started barking orders.

:eek: that's too creepy

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 25, 2011

One of the weirdest codes I saw was a guy on a tall stretcher, new but excellent nurse on his right side, me on his Left side, he goes into V-fib and started siezing or going decorticate. Monitor and paddles by the new nurse who'd never been in a code. Several of us had to hold him down while I told her how to charge the paddles, hand me 1 (she couldn't reach proper placement for both) told her where to press her paddle, told everybody to let go on 2, and the other nurse to press the red button on 3. One shock, no staff got zapped, patient went into nice sinus rhythm at a descent rate, doctor walked out of the room mumbling something about writing a paper for American Heart on 2 man defibrilation. Complete save and turf to cath lab. If Kerry reads this, you're the best. Paul. :up:

star77, MSN, RN · Jan 25, 2011

Many codes.

Ones that stand out:

12 hrs of life, born at home with a lay (not Nurse) midwife. It was chaotic and sad. Our attending was stellar. Doing infant CPR always makes me feel like the entire situation is surreal. The outcome: not good.

TCA overdose. Two attendings at bedside who happen to have fellowships in Toxicology (Luck, perhaps?). The patient kept going into Torsades, then Vfib, then Vtach, then Vfib, then Torsades. The teamwork at that code was one of the most amazing things I've ever seen. The patient had 2 art lines within 5 minutes of coding. And the patient was alive at least 48 hours later.

Bariatric patient (650lbs+). So large, how do you really get good chest compressions? Seriously. We did our best. Not such a good outcome.

I've seen really interesting codes- cracked chest/internal defib/whole 9 yards... those all did not make it.

star77, MSN, RN · Jan 25, 2011

We had a guy who woke up out of the code (was a physician) and wanted an update on his status and started barking orders.

That is awesome. I mean, really- how often does something like that happen???

nebrgirl · Jan 25, 2011

So has anybody ever heard back from a successful code, were they grateful or wish they could have "gone towards the light"...

shoegalRN, RN · Jan 25, 2011

So has anybody ever heard back from a successful code, were they grateful or wish they could have "gone towards the light"...

Yeah, I have.

He's one of our frequent flyers. He coded on day shift, right before I came on. He went flatline, but was able to get back to NSR. Was intubated, pressors, the whole nine yards.

By the end of the night, he had extubated himself.

I saw him in the ER and in the GI lab and he told me himself "I died and they brought me back". It was amazing to see him walking and talking after that.

Another frequent flyer in the ER coded on the OR table during a routine surgery. He told me he died on the operating table and he heard everything that was being said (during the code). He said he fired his primary doc because he told them to call it. The pt said to this day, he won't allow that doc to come anywhere near him. He didnt see a "light" though (according to him).