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Discussion

It was bound to happen.

During codes in my unit usually about 8-10 people show up and 5 of them are yelling out (to nobody in particular) what to do. I kept telling myself this can't be good. Well yesterday the patient was shocked while getting chest compressions. So much chaos voices yelling over the doc saying when to shock. It was like there were two code teams working on the same patient. Thank God the hands off button was pressed a split second before it had fully charged. The presser had his back to the action. I was facing it next to the cart. All I could do was yell No it happened so fast. I fully expected her to go down too because I heard the energy discharge it seems it just didn't make it to the patient. Thank God. Pt. made it through. Thank God for that too.

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OHHHHHHHHHHHHHHLordy. need more drills I am thinking. THAT is scary huh?

Talk to your hospital's "code" person (ours is a Clinical Nurse Specialist in Coronary Care) or someone in the risk management department.

At my hospital, the first in command of a code is the ICU resident in-house (used to be the internal medicine resident in-house). The only exceptions are if the attending is present or if the patient is a surgery patient experiencing a "surgical" code (bleeding out, trauma-related, etc.) In which case, the chief surgical resident can assume command.

It is not uncommon for us to boot people from the room who are not actively performing a function such as bagging the patient (anesthesia or RT), pushing the drugs(nurse), giving compressions(med student, hehe), pushing the shock button(charge nurse), or running the code(resident, ONE). Try it sometime, they will leave.

Good luck.

Seems like teamwork sessions are in order.

Glad all worked out despite the chaos.

  • Experts

I work in the ER where codes are a way of life - we don't overhead page them (we handle our own) and they run very smoothly. Get rid of the excess baggage - oops I mean people and then it will be manageable - there is no reason to have ANYONE yelling!

Codes are no fun, ever!! However, as a nurse they are a common part of the job, especially in the hospitals. The hospital I work in, keeps the code situation so quiet, that if you are not involved, you do not know there is one happening. Of course, it is announced overhead, but it is in special wording, so as not to alarm other patients and visitors. It is the best code protocol I have ever seen.

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