The worst code you've seen?

[jesshopper12]

Hello fellow nurses - I have been a nurse now for almost 5 years, and I've seen quite a few codes. So I am wondering: what is the worst code you've seen/been involved in?

[RunningRNBSN]

I work acute care so don't see alot of pt deaths. I will never forget the day one of the tech's was bathing a pt,and suddenly came out screaming that the pt stopped breathing. This 10 year old boy, who was being cleaned up to be discharged home with mom, had just gone into cardiac arrest. They worked on him for well over an hour, but found out his his K was like greater than 10. Poor kid hadn't had a BMP ordered in days, so no one had a clue his K had been trending upward. I remember mom showed up in the middle of the code to take her son home... :redbeathe

Did they ever figure out why his K+ was so high?

[CFitzRN, ADN]

Serious PP hemorrhage-----> Hemorrhagic shock-----> Full code.

After a full resucitation and 26-28 units of blood and products, she lived, no neural deficits and eventually went home with her new baby. She was dead on the OR table. I've never seen blood pour out of somebody like that. I'll never forget it.

**shivers**

Few people realize the potential for major hemorrhage with PP patients. I have to say, it was a real eye-opener for me when I was working L&D. My second patient had one and although I didn't audibly, I was screaming inside my head... Horrifying.

[PostOpPrincess, BSN, RN]

The death of a full-term baby.

[cheltoe]

15 yo pregnant drowning victim that had been "swimming" at the river with her boyfriend and his family. came in fully clothed including tennis shoes and socks. later you could hear her mother all over the er yelling at the dad for letting her go, telling him " i told you something like this was going to happen!" very sad.

[KatieNoelLPN]

38 y o male walked into the ER c/o chest pain. Gray from nipple line up. We took him into the trauma room and one nurse was putting leads on as I was starting a twin cath. As i started the line he sat up and grabbed his chest, screamed, and fell back. He flat-lined. We intubated, ran in all the usual drugs, retavase, etc. Compressions for 2 plus hours. U/S of heart at the bedside. Finally called it. Not a dry eye in the room and you could have heard a pin drop. I went with the doc to tell the family. I will never forget the look on his 11 y o son's face when the doctor told them he was gone. He jerked his head away from his mom and glared at me like i had slapped him. That was the worst day of my nursing career. I still wonder sometimes if the pain from starting that twin cath was what sent his heart over. Haunted by the whole thing.

[talaxandra]

Three arrests really stand out.

The more recent was in a four-bed bay - the ambo's arrived to take the patient in bed three home and discovered Mr X arrested in the chair. Mr X was a stable ESRF patient who'd come in for something relatively minor; he'd been a patient of ours for over five years and was just lovely. His arrest was so unexpected it flustered even the experienced ward staff - the ACN pulled open the crash card drug box while crossing the room, spilling dozens of ampoules over the floor to be crunched underfoot by the staff. Mr X didn't survive, though not because of that.

The second arrest that was really distressing was also on a long-term patient, though in this case she was still in her first admission. Ms Y was in her early thirties and had presented about three months earlier with progressive weakness - she was diagnosed with Guillian-Barre and despite early intervention quite quickly deteriorated. She crashed and was sent to ICU for almost a month and a half, but had significantly recovered and was about a week post trache decannulation. Still weak, she was now sitting out with a lifting machine, and waiting rehab. Her room was filled with soft toys, flowers and cards from her students, because Ms Y was a much lovely primary school teacher. She had been fine at 06:50, when her night nurse checked on her before hand over. The morning staff were completing their planner at 07:20 when one of them had a strong feeling he should check on Ms Y - he found her in full arrest. Once again, familiarity with the patient and shock at the unexpectedness of it flustered the responding staff, who had to battle clutter to get to her, and once again resuscitation was unsuccessful.

Finally - I was in charge one night. All was serene, even though we had an agency nurse replacing one of our older, experienced but easily flappable nurses. The agency nurse was seven months pregnant, and this was going to be her last shift before taking maternity leave, but she'd had such a good shift she told me she was thinking she might work another night the following weekend. At 2AM she came up to check a heparin flask for one of her patients, a mother of three in her late thirties who'd presented with an MI and then stroke on the cardiology unit. The agency nurse was awesome, and a friend was visiting, so I didn't check the flask to the bed. Twenty eight minutes later the agency nurse raced around the corner to the nurses' station, where I was sitting with my feet on the desk, colouring in my nails with whyteboard marker and chatting to my friend.

"She's dead!"

I knew immediately who she meant - I tore around the corner after her so quickly I later found my pager by the window in another aptient's room, where it had flown from my waist.

As I ran up the corridor I thought, in no particular order, of the patient, her children, the heaprin I didn't check, the agency nurse going into labout, the Coroner's Court, the reaction of the patient's already unhappy husband, the fact that I had whyteboard-coloured nails, and the fact that at least this didn't happen to my flappable older colleague.

Mrs Z was blue. Her heparin infusion was running at the right rate,a dn when the agency nurse, now distraught and clear she'd not be working with us again, reported that she'd been awake when the new flask was hung. The team worked on her for almost an hour before calling it a day, and though they didn't tell me (leaving me worrying all night) when they rang the coroner he wasn't interested. As Mr Z told me when he came in with his three young girls, they'd been expecting it - Mrs Z was a vasculopath who never expected to make thirty-five: her mother, grandmother and great grandmother had all died early, too.

Thinking back on these events I realise that it's the emotional aspects that make these arrests more distressing to me than the young boy who bled out from rectal varices; the elderly man who was resuscitated five times in an hour despite his extensive medical history (including dementia and metastatic cancer) until the consultant could finally be reached and allowed us to stop; the arrest in theatre I arrived at five hours in, when the poor CAGS patient whose aorta had adhered to her sternum was receiving her hundredth unit as an anaesthetist kicked over a glass drainage bottle, spilling a litre and half of blood over the floor in a nest of shattered glass; or the poor woman who had all stops pulled out, including PR resonium, and whose family (arriving after we stopped) said "at least she died with dignity."

[CathyLew]

ok, Ill lighten it up. Not one I was at, but heard our nursing instructor tell it... Guy codes. Crash cart comes in the room--gets hooked on patients foley, which gets yanked out. Urine on floor. Code team member comes charing into the room, slips on urine and slides part way under the bed. Not so experienced nurse grabs paddles and goes to zap the patient....over the gown. Result is smoldering gown. Code team then is standing over patient patting on chest to make sure smoldering gown does not catch fire.

Oh, and one at our hospital in the ER. Everyone around patient, one of our surgical MD's comes in... figures he will zap the patient. Never yells clear--zap's the patient while the ER nurse is still in full contact with patient. She hits the wall and crumples on the floor. The code team then goes to her aid. The surgeon didn't know he did that, and though she passed out! She had palpitations for a few days. Patient made it.

[TMH2010]

ok, Ill lighten it up. Not one I was at, but heard our nursing instructor tell it... Guy codes. Crash cart comes in the room--gets hooked on patients foley, which gets yanked out. Urine on floor. Code team member comes charing into the room, slips on urine and slides part way under the bed. Not so experienced nurse grabs paddles and goes to zap the patient....over the gown. Result is smoldering gown. Code team then is standing over patient patting on chest to make sure smoldering gown does not catch fire.

Oh, and one at our hospital in the ER. Everyone around patient, one of our surgical MD's comes in... figures he will zap the patient. Never yells clear--zap's the patient while the ER nurse is still in full contact with patient. She hits the wall and crumples on the floor. The code team then goes to her aid. The surgeon didn't know he did that, and though she passed out! She had palpitations for a few days. Patient made it.

Oh my goodness did this really happen!! Wouldnt that be a sight to see:uhoh3:

[Spacklehead, MSN, NP]

An otherwise healthy infant who should not have died - enough said. The infant's face is permanently engraved on my mind.

[CBsMommy]

The one and only code that I have ever witnessed was when I was in the PICU with my son who had just had surgery for his pharyngeal flap. We had been sleeping the night through and about 0530 his IV started beeping. I called the nurse who came in, in rather a hurry (she never did shut the beeping off). I got up to go to the BR and walked past our neighbor's room. The doc was on a very small child doing chest compressions and everyone was standing inside and outside the room. The mother was in the hallway watching everything (I will never forget the look on her face) and every single person was silent. I saw the parents leave later that day with just a small, soft, pink blanket. So far the only code I've ever witnessed but I'm a first semester student. I think that one will always stay with me though as I saw it from the eyes of a mother and not from the eyes of a nurse.

[traveler85]

I've only seen a few, as I worked on a low level med-surg unit. First was when I was orienting to the floor and a code was called in our ICU. I got to go over, found out it was an elderly woman coding for the fourth time that day. When I got there, her skin was a lovely shade of blue-purple, and her legs were quite mottled. The code lasted for almost an hour, as the doctor went out to talk with her family about ending things. Just before it was called, the patient got a pulse and pressure back, however I think she died later that evening.

The second was when I was a student doing my maternity clinicals. I was in the NICU on my last day of clinicals, when the nurse and I were alerted that we would be taking a 25 weeker out of an emergency c-section. They brought the baby in straight from the surgical theatre and coded her immediately. Her initial Apgar was a 1. I'll never forget it because I was standing there praying that she would survive and this would not have to be my first experience with losing a patient. Thank God, she did resuscitate, though I don't know what happened to her afterwards.

[1blue&1browneye]

I was the charge RN one weekend with a patient assignment and an orientee. As charge RN, I was helping out another RN by transferring her patient to another unit to initiate bipap (can't do it on our unit). This patient had some sort of bowel resection, and was currently minimally responsive, febrile, etc. (Next time I will forgo transfer and call rapid response :) ) Fast forward to arrival on new unit: slide patient onto new bed, patient begins to spew froth from mouth. EKG patches slapped on, beat...beat........beat.....................call the code. On another unit. With an orientee, oh my poor orientee. This was a rather large woman, with a wound vac on her large abdominal incision. With each compression the contents of her bowels sprayed out. She transferred shortly thereafter to the ICU, then to the OR (perfed bowel - go figure), and eventually passed away.

And to this day I still can't help but wonder.....what if she would have coded in the elevator??

Wow is all I can say.