Sunday, February 19, 2006

Defining Codes

Thanks to Teni, here's an explanation of codes:

"Code" may refer to many different things. Most of these are used in the hospital setting and make sense to the hospital personnel. Most of the time "code" refers to Code Blue, as in
"A patient coded last night."

Code Red = Fire in the hospital!

Code Brown = a favorite among medical residents. Means that someone has gotten a whiff of a patient's poop and is signaling the team to move farther away from that location.

Code Pink = Baby disappeared (used in newborn nurseries, when baby snatchers make off with a newborn, most often, NOT their own)

Code Blue = Patient found unresponsive, often not breathing or with no heart beat and needs resuscitation with CPR, electric shock in an attempt to jump start the heart, medicines to try to make the heart pump regularly, or intubation (tube down throat) to let a machine help them breath. The rates of success of code blues are usually dismal. Occasionally, in the young or healthy, there may be a quickly reversible cause of the unresponsiveness. More often, especially in the hospital setting with older, sicker patients, patients are not able to be brought back to life, and even if their heart is restarted again, depending on how long the patient was unresponsive, there may be damaged neurologic function. The interventions to try to bring someone back are not benign. CPR can lead to cracked rib bones. Often needles are stuck in the patient in an attempt to try to get intravenous access to administer medicines. Electric shocks are not pleasant. When patients are admitted to the hospital, the admitting physician should ask the patient what their wishes are for resuscitation. Sometimes this can be phrased strangely by the physician (in a poor attempt to try to explain in common language). A bad example I've often heard "If your heart stops do you want us to do everything we can to try to restart it?" If I were the patient OF COURSE I want the doctor to try to save me. But I don't know that patients truly understand what "everything" includes. If people were to be present at a code blue, I don't know that they would chose to have that done to them. For those who want everything (CPR, electric shocks, etc), they are given the label "FULL CODE." Those who do not wish for these extreme resuscitation methods are either "modified code" if they want some things but not others, or "no code." I think it is important for people to understand that "no code" does not mean that doctors write you off and won't try to save you. If you are sick and need antibiotics, or have a dangerously low blood pressure, we will give you intravenous fluids to get you better. "No code" just means that in the event that you were found unconscious, we would do everything we could, but would not use the extreme measures of CPR and electric shock.

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