A REAL Code “Blue”

A Real code

  “A real code, and real CPR is nothing like television or movies would have you believe. Its not a sexy doctor dramatically pounding his fist against a patients chest and yelling “Live Goddam it!” while a monotone flatline sounds from a monitor in the background and nurses somehow weep and swoon simultaneously. A real code is actually far worse; it is a violent, cold a cruel scene. Chest compressions have to be deep, hard and fast. All sex jokes aside, it is a physically demanding action usually resulting in broken ribs and internal organ damage. Large bore IV access is a necessity for the massive doses of epinephrine, lidocaine, and other potentially toxic medications that ironically if they weren’t capable of restarting a heart, they would surely stop it.

Successful resuscitation is not commonplace. What typically happens is a temporary restoration of vital signs that last hours, maybe days at best. In elderly or seriously ill patients, we often wonder if it is worth causing all the physical trauma a code entails. But if a person can be saved, and wants to be saved, who are we to decide their fate?” -Kelsey David Burnham Thank You for Dying: A Hospital Memoir.


51Uov7UieWL._SL110_Thank you for Dying:: A Hospital Memoir

(Photo courtesy of Mark Fisher and Heather Thornton)


7 thoughts on “A REAL Code “Blue”

  1. You’re absolutely spot on. Wouldn’t it be nice if we could minimize the need for these attempted resuscitations by having people participate in maintaining their own health rather than believing it is the responsibility of the doctor? I would rather see these type of resuscitations for acute trauma and accidents.

  2. Truth. I work in an ICU and a lot of the PTs there are mostly elderly; we feel awful if they need to be coded and it’s usually just a temporary fix.

  3. Sobering and not even a tiny bit like Grey’s Anatomy.

  4. Thanks for the real insight on how these procedures go. I’ll admit I thought Grey’s Anatomy was how things went. Keep up the great work!

  5. You forgot the vomit, blood, poop etc…. (I was in EMS for 20 years…most as a paramedic).

  6. Been there, seen that. The only time you hear “Live damn you!” Is when someone (me) is screwing around in BLS class.

    By the time a real code is finished, there blood everywhere from IV starts and it looks like someone blew up a med supply warehouse there’s so much debris.

    Even if you do get them back, it’s no barrier to a terminal extubation 2 weeks later. I wish more people realized that when they say that their 98yo mother is a full code. Especially when she weighs 78lbs and has 6 major comorbidities.

    At that point, it’s just cruel.

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