Code Blue on the floor: a lot like a Code Blue in the Emergency Department, except we have to run to the elevators, take a ponderously slow ride up to whatever floor they’re doing compressions, and then run some more down some endlessly long corridors till we find a room full of telemetry nurses looking out expectantly the doc and me and the ICU nurse (who flew down three fights and turned an ankle in the process.)
The patient, of course, is already dead. We just haven’t decided yet to make it official. This is one of health care’s best kept secrets: once a patient has gone VSA he is, for all intents and purposes, dead. Chances of bringing him back are minuscule — and yet not tiny enough to give up all hope of resuscitation. Once even I shook the hand of a woman leaving the hospital who coded on the ambulance gurney while I was triaging her the week before. So we continue. I pull out the drugs, and direct traffic, while the ICU nurse pushes epinephrine and atropine. The ICU Respiratory Therapist manages the airway. One of the tele nurses is assigned documentation, and there’s a short rotation of three nurses for chest compressions. The doc yells at one of them: harder! faster!
After the second round of drugs, it’s becoming clear the effort is futile, and we settle into the routine. Nurses doing compressions change every two minutes. Epi every three. When we briefly pause for the change, the monitor shows asystole. The ICU nurse and I chat. The RT cracks wise with the doc, and the tele nurses giggle at this, We banter back and forth. We joke. Another of health care’s best kept secrets: we chatter like budgerigars during codes. Then, through a crack in the privacy curtain, I see just this: two fidgeting hands clasped across a flannel covered belly.
Shit. There’s a patient in the next bed. I make frantic hand signals. I finally get everyone to shut up. A couple of minutes later, the doc pronounces. The room is silent. I can only imagine what he guy in the next bed is thinking.
And this isn’t the first time this has happened in my experience. I can remember a few occasions in the Emergency department where the guy in the next bed was a child who for various reasons couldn’t be moved.
So what do we do about the patient in the next bed, apart from shutting up?