What is exactly going on when a patient "codes for hours"?

Question

...and the staff is running around like a chicken with head cut off?

What exactly went on (ex: hypovolemic shock due to hemorrhage), what did you do for this patient, and most importantly--was there a battle of agonist-antagonists meds?

Answer 1

A "code" indicates an unstable medical condition, typically arrhythmias (although respiratory problems are frequently involved as well.)

If it goes on for hours, it's probably a case of developing a lethal arrhythmia, treating it, going BACk into that or another arrhythmia, treating it, and so on.

If hypovolemia is the problem, then "filling the tank" with transfusions and IV solutions should help - however, there can be organ damage, and that needs to be treated in an ongoing fashion. Also, once you start giving massive amounts of fluid, it can cause swelling in other parts of the body, and that, in turn, causes other problems. You're also prone to electrolyte abnormalities, clotting problems, and a host of other imbalances.

I doubt that a "battle of agonist-antagonist meds" entered into it at all.

Answer 2

Usually a "code" refers to a cardiac arrest which does not go on for hours. This patient was critical due to hemorrhaging, but there must have been a heart beat and some low level of blood pressure to provide oxygen to the brain. Treatment would have included volume replacement with fluids and blood components plus an effort to stop the source of blood loss. Vasopressor medications may have been used and there is a complex balancing act there related to renal blood flow. Oxygen would have been used to maximize O2 delivery to tissues with low blood perfusion. The main goals are to prevent cardiac arrest and stop the hemorrhaging while preserving vital organ function - especially brain and kidneys..