When does a "code" happen?

Question

At what stage of shock (early, progressive, or refractory) has code blues been called? Is it easy to "catch" a code in the reversible stage to provide rescuscitation early? And how keen do sense have to be to determine whether a patient is in early stage (mild tachycardia)? THanks.

Answer 1

Code blue is usually called in the event of cardiac arrest or respiratory arrest or both with the aim of reviving a patient.

A code blue cannot be announced just because of deteriorating patient's situation. In such situation the attending physician will be alerted instead who will decide for an appropriate management of his patient. The patient will be put on close monitoring or probably will be confined for an intensive care.

The entire staff are usually sensitive to the critical patients. A sudden drop of vital signs and generally worsened situation usually keeps the entire team alert. An experienced medical staff usually recognizes a patient in pre arrest stage- calling the code before the actual arrest takes place. Of course, you cannot recognize an impending arrest to those who had unexpected sudden cardiac arrest like in myocardial infarction patient.

There are extreme situations also that a code will be called without arrest. We had a patient before who had a sudden rupture of esophageal varices. The attending physician with his team tried to manage but there was a massive bleeding that was incontrollable by their atempts to abort it. The worsening condition of the patient who could have arrested anytime, prompted for a code blue despite there was no actual arrest not even nearly arrest.

It is a very good point to say it is easy to "catch" a code in the reversible stage to provide rescuscitation early. However, that would be in a case to case basis. You will not be doing measures to revive a patient whose heart is still beating and is still breathing. As I mentioned, the attending physician will do the job in reversing the worsening condition of his patient before an arrest takes place.

Answer 2

a "code" is called when somebodys heart stops, they stop breathing, or both