Ugly Code

Had a patient code the other night, he was my patient, 59 yo male, hx of chirohsis (SP?) among other things, iddm, sz disorde... Had a k+ of 6.1, md order kayacelate enema, i gave it, pt was axox3, vss, complained about the enema, didn't hold much in, called md to get a amp of d50 and 10u or reg order (i have absolutly no use for kayacelate unless it's a chronic problem, ie esrd), he orders it po, whatever, go to give it 30 minutes or so after i originaly saw the patient. he was laying up against the bed rail, not responsive, i repositioned him in the middle of the bed, thought he had a sz, resps were about 12-16 and erratic, sturnal rub, opened his eyes real wide, couldn't palpate a pulse, couldn't hear one, by this time ( i had called for help) pox machine was on, pox86% ra, pulse 40's. Put on a rebreather, pox up to100%, still not responsive, called the code, did a fs beofre teh code team arrived, it was 58 pushed an amp of d50, code team came, pushed an amp of bicard, "how bout some insulin" nobody listened, chest compression started, note that the code team is all residents except for the anesthesiologist. Compressions were adequate at best, hr in the 20's very erratic, epi pushed, more bicarb, more dextros (finally some insulin) 1st cvp in the artery, resident running the code starts to defib, she wasn't excellent at it, the one paddle was on the lead for the moniter, got a rate of about 75, lost it, defibed again, on the leads againg, uh hello?!?! Teh nsg super and i just sort of looked at each other like, this guy is already dead. more drugs pushed, 2nd cvp properly placed, intubated by resp therapst, anesthesia was in or, or somthing. few more defibs later, few more drugs and 45 minutes total code time he was pronounced. I finally get out of the room after wading through the mess of stuff, teh nurse i was working with tells me, as I'm dripping with sweat, "I did, this and this and this...." you shoudl of left teh rom when the code team came, i'm not doing anything else for you" If she was a guy i would of punched her in the head.

That was the first patient that I coded that din't at least make it to the Unit.