The worst code you've seen?

I once witnessed an entire (improperly applied) IO device become completely lodged in a patient's sternum. I think it was straight downhill after that. Nothing worse comes to mind.

I once witnessed an entire (improperly applied) IO device become completely lodged in a patient's sternum. I think it was straight downhill after that. Nothing worse comes to mind.

Ooh that's bad!

But so far the worst I have seen was my own pt! My 2nd night off orientation, my patient was stable,CHF,CMP hx EF of like 15% (sick man) just getting over a SBO had an NG. He was doing better, said he felt better than he had in a few days (should've been my first clue). we joked about what he was going to eat first tomorrow when they took out the NG. Then around 2am telemetry shows Vtach went into room and pt was bugged eyed looked like he was seizing. I will never forget his face. Then he was out,nonresponsive. Called code docs arrive pt was in PEA. Docs coded him for 15 mins,tops! I mean they barely did anything and was taking no suggestions. Went to tell family and started to clean pt up. As we rolled him over my coworker says I can feel his heart beating!

So we call doc back in and try to code again! That lasted about 15 mins and we couldnt get a pulse. It was awful.

Went to tell family and they were rolling around on the floor,kicking,screaming,throwing things. And I mean screaming! Pts were getting scared.

It was horrible.

8 mo old baby girl (former 23 weeker), had a rough life to begin with, at this point almost no bowel, hugely enlarged liver from 8mo of tpn/il, terrible lungs, practically intubated since birth, (always too unstable to get a trach), bad head coded every other shift, well this one was her last. 6+ hrs of compressions, 2 shocks, meds and eventual placement onto ECMO which still didn't help her, she was bleeding out so bad from everywhere & they couldn't even get the cannulas in place in her neck...all the nurses just wanted to end it (it was long overdue) but the docs kept pushing, with her parents in the background asking for a heart transplant, her heart really wasn't the issue at that point...I think she just finally had enough and wanted to be with her twin sister who had passed months ago :redbeathe

A gentleman came in for elective surgery, then got pneumonia afterwards and an ileus. So the nurse who had the patient sent in someone else to assist with intubation (first mistake), and she didn't know the difference between a sat probe and an ETT. I had asked when I walked in if we had suction set up. The RT and the RN confirmed it was ready to go. So they put the patient out without warning him, and he went down with a terrified look on his face. The doc (a surgeon) sticks the laryngoscope halfway in and the patient pukes EVERYWHERE. I yell for suction, the doc yells for suction, and we have no suction. The patient continues to ralph all over the bed, floor and my shoes- I turned him on his side- and the doc starts screaming. He was so busy screaming at this nurse that was just pulled in the room to help, and she was so busy crying that no one was fixing suction, or watching the patient's airway. Patient takes turns between not breathing and puking, RT finally gets the suction together, and the tube goes in. HUGE mess in the room. The doc storms out, the nurse is in tears. Finally got the bed somewhat clean and I walk out and the family was standing on the other side of the wall. There is no way they didn't hear the doc screaming. But there he is at the nurses' station telling the nurse and RT how well they did and what a great procedure it was, loudly so the family could hear. I went to the nurse assigned to the patient and asked her to stay in the room, and slunk back to the ER. Swore that night that I would be the best witness a suing family ever had if it came to that. I've never seen such a cluster, and I thought there was no way the patient would escape ARDS. Apparently he did terrific, they Lifeflighted him out that night, and he was discharged a week later.

Moral of the story- check the suction and oxygen yourself, every time.

Just this week had a 51 yo F who was transferred to us from an outlying hospital that didn't have a nephrologist for "acute renal failure." Apparently coded in transit, got her to the floor (shock to everyone she made it) and began to bleed from every orifice, was in full blown DIC. Coded her 3 times, each time blood going everywhere, while we continue to run in more PRBCs only to have them leak out again. Turns out lady was end stage liver failure due to EtOH abuse who was pretty nasty to her family in life, so they refused to make any decisions on her behalf. Passed after the 4th code was called, after a huge bloody mess was made and staff morale was taken down a few notches.

Guy who bled out from ruptured esophageal varices (undiagnosed until the bleed started). That was pretty bad.

A 4 y.o. was in a wagon that got run over by a large pickup truck. She had an open skull fx which was probably the only reason she was able to be resuscitated (although briefly). I'll never forget how gray and cold she was when I intubated her. she died about an hour and half after we landed at the pad, at least her parents were able to get there and see her before her heart stopped again. I hope that was some consolation to them.

Also had a 7 y.o. commit suicide with a pistol to the chest after breakfast one morning. We coded him the whole flight into the hospital without success. I always wondered what happened to make him do that? According to the family his father was angry and said something to the effect of "you just wait til I get home tonight"....

I knew there were times when I made suggestions, and the idiot MD's and other RN's running the code didn't want to listen. Unfortunately, the outcomes were eventually poor. There are just too many "chefs in the kitchen" during codes.

I was transfering a patient from the bed to the wheelchair and he had his arms around my neck. When moving him, he became limp and I said for him to please help me and stand as tall as possible. He was 300 pounds, 6 foot and I am 175 pounds, 5 foot 3... I looked at his face and eyes were rolled in the back of his head. He fell on top of me and I heard his legs brake. I screamed for help and of course he was in the last room at the end of the hall. RN's came in and said; is he a code? I said, no a DNR, but get him off of me. He actually died on top of me. I will never forget this. I hurt my back and it was not fun.

The wife came after I called her and she was worried he died all alone. I told her that I was right with him and saw him take his last breath. I did not tell her that he died on top of me...

I wasn't involved, but it' the code story everyone loves to tell.

This guy came in septic, pretty much already gone. He was swollen everywhere, had a colostomy, sores, etc. He coded while they were still hooking him up to our machines.

Code called, compressions started, when they would compress, his colostomy bag would fill up with a foul smelling pus-like discharge, definitely wasn't poop. It also begin oozing out of his mouth and the smell was horrific. One girl doing compressions actually had to throw up in the sink while another took over.

They didn't code him very long as it was pretty obvious nothing was bringing this guy back.

Coded a post-op patient the other night in the ICU (where the nurses are supposed to be ACLS gurus). The team leader asked for the lifepak to be charged to 300 and the nurse at that station did not know how to increase the energy! A delay in defibrillation of course, and the patient did not survive. If you don't know how to do something in a code, sit back and observe at a particular station until you are 100% comfortable and competent.

A ruptured pulmonary artery...looked like a very bad crime scene...blood all over everything and everyone. sad, obviously didnt make it.