Code Blue

"Attention! Attention! Code Blue in the holding area Repeat ......."  I was quietly writing some notes on one of my patients at 2:30 in the afternoon. I had a post prandial urge to snooze and could envision the bed in the call room. It would be so nice to just lay down for 10 minutes but I knew that was not going to happen. I quickly got up and made my way down to the holding room which happened to be only just down the hall from where I was. Given my proximity I was the first "doctor" on the scene. "Oh great! I thought, it is just me, what am I going to do?" Immediately I started recalling all of the life saving procedures that I had been taught and read over about 1000 times. I ran up to the side of the bed where all the nurses had gathered and saw a lifeless shell of a body laying in the bed. It was a 95 year old women with aspiration pneumonia who had stopped breathing and had no pulse. 

The nurses moved out of the way and I yelled for a crash cart. I immediately listened to her chest and could not detect a heart beat and there was no detectable pulse. I check her airway and could find no obstruction. I yelled out for her code status and I was told she was full code which meant full effort resuscitation  was in order. I started doing chest compression and yelled out for an ambu bag. One of the nurses started bagging the patient. At this point all the residents started to descend on the scene, thankfully. I moved out of the way so that they could take over. We usually switch off doing chest compressions to avoid fatigue.

We put a monitor on the patient and confirmed that she was in asystole which is one stop before complete flatline. We kept doing chest compressions and started to push various medications. After 15 minutes of running the code we were able to bring her back. We had to intubate her and have the ventilator breath for her. We stabilized her and transfered her down to the ICU. The patient has no family that claims her, no next of kin, no friends, nothing. It was a sad situation. She never fully regained consciousness and later that afternoon in the ICU she died. 

What a day! This was just one of my patients from the day. There is never a dull moment and you never know what is lurking around the next corner.