Wednesday, April 7, 2010

Should doctors be running futile codes? (Code Blue)

In the hospital, if you hear "Code Blue," that often means there's a patient who needs to be resuscitated. There are many instances when the resuscitation is "futile." You know that the patient's not going to get revived. However, you still feel obligated to go through the steps of running the code. I realize this is going to sound terrible, but I've even witnessed situations where futile codes became opportunities for medical students and interns to "practice" certain procedures (like a pericardiocentesis, a central line placement, intubation, etc.). Perhaps you've been in those situations as well. 

So why am I writing about futile codes? The other day, I was speaking with someone about advanced directives and "code status." Some people want to be a "full code," even if they're dying from a terminal disease. Others want the letters "DNR" for Do Not Resuscitate written clearly on the chart. One big problem is that many patients and family members don't discuss code status with their loved ones. As a result, family members are faced with very difficult situations when their loved one is being supported on a ventilator and when they're asked if they ought to "pull the plug." We live in a world where advances in medical technology have made it possible for medical professionals to sustain life, but is this always a good thing? 

1 comment:

  1. DNR situations are very complex and even more stressful in the prehospital environment where an handful of EMTs and Paramedics are faced with making the decision to resuscitate and then performing the resuscitation in the patient's home. Often times with family gathered around.

    Me and a few other paramedic bloggers wrote about "Going through the motions" - a theme similar to your post earlier this year.