Another night, another code, another lost patient. During this month's rotation, the Night Floats the past two weeks had no worse than calling security to help catch a disoriented, combative little old lady; and now in the last three days there've been two codes on the floor. This last one we ran for 35 minutes, shocked more than I can count, and ran through just about every med in the cart, to no avail.
My pager goes off: "There's an emergency in room X". The JAR and fellow are already in the room. He's bagged. V-Fib. Clear. Epi. Shock. Shock. Shock. RT is here. Intubate. She starts compressions. I shoulder in and relieve her--compressions are extremely fatiguing and you need to relieve the person delivering them. Rhythm? Pulse? Clear. Shock. Pulse? Compressions. The JAR and fellow start placing chest tubes on both sides. Stop compressions. More Epi. Rhythm? Pulse? I hit the charge button and grab the paddles. His chest is a slick of conductive gel. Clear. Shock. Pulse? Round after round. V-Fib. Pulse? Shock. Shock. V-Fib. Vasopressin. Bicarb. Amio. Lidocaine. Torsades. Magnesium. Do we have Bretylium? We're running out of ideas. Finally we call it. The pitched whine of the defibrillator charge chime in the background. We've given the unfortunate fellow every chance we could. A medicine resident turns it off.
His mother is a huddled wreck wrapped in a blanket in the waiting room. The Chaplain is stuck in another code situation. We sit down with her.
Later, after the rest of the family arrives, there's a horrific wail that echoes down the corridors. The other residents are dealing with an MI in the unit. I'm sorry, we tried everything. I know you all did. Thank you. His wife's knee is quaking.
Monsters & Goblins come out at night.
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