Sunday, May 15, 2011

Code Blue



Code Blue. It is a term I never enjoy hearing over the loud speaker at my hospital. I have only heard it twice before, but this time, it was on my unit. As I was passing my morning medications, I heard “Code Blue, 3rd floor, Room 18.” I am still thanking God that it wasn’t my patient and I didn’t have to call it. Code Blue, you see, is a cardiac arrest. A patient isn’t breathing, his heart may not be pumping, something is definitely very wrong. It’s the worst of all announcements that can be heard, and Friday the 13th, Code Blue became very real to me.

I’ve heard the code called before, but it was always a different floor, a different unit. I’ve told myself that if I could, I would go to the codes, to experience it so that if…no wait…when it happens to my patient, I will be as prepared as I can be (if you can even prepare for that). As I heard the 2nd announcement, I forced myself to stop what I was doing and head to room 18. 10 people were already in the room, doing chest compressions and forcing air into his lungs. The crash cart was opened, pads were on his chest, and no pulse could be found. I weaved through the crowd of people and found my charge nurse, who was recording (all the medications, shocks, pretty much anything done to the patient). I helped her keep track of time, what we’d given, how long it had been since the last dose of epinephrine or atropine. The ER doc arrived and attempted to intubate the patient, respiratory therapy was giving him air, an ICU nurse was drawing up medications, the CNA was doing compressions, the House Supervisor was keeping an eye on the heart rhythm.

After 22 minutes, 5 rounds of Epinephrine, 3 of Atropine, 5 shocks, 200 mg of Amiodorone, the patient didn’t make it. No one was sure at the time, but he was admitted for sepsis and everyone was thinking he threw a blood clot in his lung. I stood there, not really sure what to think. I gave the patient’s nurse a hug, and asked him if I could do anything for him. The strangest part of the whole experience was that the staff didn’t seem all that affected by the event, like they were just doing their jobs and now would go back to what they were doing before. Now, that could be a defense mechanism or they may see this all the time, but I hope that I never get that way; that each Code Blue upsets me, and I don’t leave that room the same. I can imagine it gets easier to deal with death, but all I could think about was where is that man now? Is he pain free, hanging with Jesus or not? All I could do was pray for him and his family.

I know the day will come that I am put in that situation. I will be the nurse that has to call for help because her patient is crashing. When that day comes, I will be more prepared for having this experience but I can imagine it will be like it’s the first time again.

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