The last code I was involved in wasn’t my parent. I was outside the room, documenting in the hallway. The patient’s significant other came out to say the patient was having trouble breathing. I went into the room, the CNA or PCT, ran to get a nasal canula. The patient’s primary nurse came into the room. The patient was standing up, we brought him back to bed, as the primary nurse call our supervisor. As our supervisor entered the room, the patient stop breathing, everyone immediately felt for a pulse. I don’t know who initiated ode, everything happened so fast, but instantaneously, the bed fell flat into CPR mode, the code button pushed. The tech and I began compressions, once we became tired trading positions — the room filled with people. Everyone in the room had a task and location.
#1 Compressions
Everyone who works with patients in a hospital is required to be CPR certified. Anyone certified can do compressions. There are at least two individuals, one on each side of the patient, while standing at the shoulder or chest area. I have also seen two people teams on each side. Compressions are exhausting, and being able to switch out is critical.
#2 Respiratory
The respiratory therapist is present at every code. There are two and positioned at the head of the patient. They are there to bag the patient and assist with intubation if necessary.
#3 ICU Nurses
Two ICU Nurses stand one on each side of the patient stand by their arms. One of them watches the monitor and defibrillator, the other giving medication. I have also seen the ICU nurses taking blood, but the laboratory has come in to get blood samples as well.
#4 Leader, Recorder, and Hospitalist
The leader is an experienced nurse; depending on the hospital, they are either the one assign to be the leader of the code team or the ICU supervisor. They oversee the team and help if needed. The recorder is usually the supervisor of the floor or unit; they record when the code begins, what medication, the amount, and the time given. The hospitalist is there to observe and assist the leader.
#5 Primary Nurse
The primary nurse is there to answer questions, including basic demographics, diagnosis, and what happened to lead to the code. A big, colossal tip here, always have your brain sheet with you because in the moment you will not remember anything, I know it’s happened to me.
#6 Extra Staff
Extra staff will be just outside the room. They are the extra hands to grab needed items and place STAT orders.
A well constructed, educated team and staff will wield better outcomes. Have you been in a code, were confident or overwhelmed?