A Hundred CPRs Later...

Emergency Room
Surgical Trauma Rotator

It was just another regular evening on a 24-hour duty at the Emergency Department (ED or ER, for most of us). I was one of the only two Trauma Interns on duty and was just taking a break from charting a very long list of patients--ranging from those who fell from stairs to those intoxicated madmen stabbing each other to death! It's a rare occasion for Trauma ER to have no patients in 3 hours time so I grabbed that opportunity to go out and buy a cold drink at the ER kiosk (it was already around 1:00 AM by the way). 

On my way back to our station in the Acute Care Unit (ACU), I could see the triage area was already in a mess. ("Triage" by the way is the place where patients would go first before they are assigned with to different departments). There were piles of stretcher-beds (with patients on them, of course!) and hordes of their watchers waiting to be seen by our Triage officer (TO). Where was the TO, you asked? I wouldn't be surprised to see her in the resuscitation bay (RB), well--resuscitating a patient. And it took a few seconds to find her. Indeed, I was not wrong: there was an on-going "double code" at the RB.

Okay, let me tell you what a "code" is and what's a "double code". 

Maybe you are all familiar with the term "Code Blue" in most medical drama series. Yes, that's what we call a "code". If a patient comes in with a zero blood pressure, zero heart rate and zero response (call it a "cardiac arrest", sure.) The health worker (usually a doctor or a nurse) would call a "code". You will hear us shout "CODE BLUE!" or simply "CODE!". It means, all those who area available at the time, or even if you are not but your case is kinda... manageable... you'll have to respond to the code. To assist the team who will resuscitate a patient. There are different roles to be filled in a code, but that would be on a different story, I guess.

Now, what about a "double code"? Well, you can already guess it right.

A Double code is simply having two codes at the same time. One code blue is already exhausting and would require all the available health personnel to be present, to help out and do the Basic Life Support (BLS) or even the Acute Cardiac Life Support (ACLS), to save a patient whose heart suddenly stopped. Now multiply that to two and take the number of the personnel by half. That's one helluva job to do! Plus, it's that time of the year where we have no Clerks rotating in DEMS (Department of Emergency Medicine). So yeah. Bummer!

So I rushed to our station, put down my cold iced coffee, grabbed a box of clean gloves, asked help from another intern and went to the RB to help. 

14 minutes later and both patients were revived, Alhamdulillah (Praise be to Allah). I thanked the IM intern who helped me and we all went back to our respective stations. By then, my iced coffee has turned into this weird bilaminar sediment of a thing. And as I sipped that mysterious drink, I suddenly remembered my first experience with "codes". (I blogged about it years ago here: His last whisper in case you want to read it)

It was such an eye-opening experience for me. I remembered that day as if it just happened recently. The chill, the shiver, the feeling of helplessness I had... And now, after dozens, no, a hundred CPRs later... I still feel the same...

 

I may now have the needed decisiveness to step up and call the code. I may now have the skill and knowledge of the basic principles in participating in a code (my deepest gratitude to these two departments: DEMS and IM). Yes, I may now have the courage to look at the face of the patient I am resuscitating... Yet I still wonder how much of me can really help him or her to go back to who he/she was before... We all know that doing BLS in most patients end miserably. And based on our daily experiences head on, they really do. That is why, even after a hundred CPRs in this hospital, I still feel the same way that day I first experienced a "code": stunned, helpless.

Indeed, what my younger self said years ago now rings true:

" To save a life was never an easy job, and to lose one is a bigger burden you will carry all your life."

Funny that I am now being reminded by my younger self about life in the hospital... Especially now that I am nearing the finish line... And as I sipped the last drop of that caffeine-filled concoction from a once cold drink contained in a plastic cup, I wondered... Will another hundred CPRs more change the way I feel now?

-Overly dramatic me,

Ahmad