The Emotional Fatigue Of A Code Blue

“Push FAST, GO!” I heard our ICU attending say as we hurled our patient’s stretcher down the hall towards a vacant ICU bed. “PEA arrest – as soon as we stop, someone needs to jump on the bed and start chest compressions!”

Note: Details have been altered for privacy.

After arriving, I locked the bed and proceeded to gather myself mentally for the situation at hand. I removed my white coat, put on some gloves, and stood in line for chest compressions. As a resident, I’ve run a code twice and performed chest compressions more times than I’d like to remember, so it wasn’t a lack of experience which gripped me. It was the spouse who wailed desperately as we faced a losing battle in resuscitation.

As my co-resident placed an arterial and central line, I was reminding myself of what I needed to do.

“Elbows locked. One hand interlocked across the other over the sternum. Rate of 100 beats per minute. Allow just enough time for chest wall recoil between compression.” Okay, I was ready.

We checked for a pulse. Still PEA arrest. I proceeded to deliver compressions and ended up giving a total of five cycles during the code. Looking back, I remember how emotional the room was. Not a single unnecessary word was uttered as the spouse gripped hopelessly onto the patient. I felt a profound sense of exhaustion after the code ceased and time of death called. The physical demands of administering chest compressions were insignificant next to the emotional aspect of not being able to save a patient… not letting the spouse see her loved one spring back to life and live together happily ever after.

I wiped the sweat off my brow and caught my breath as I left the room – defeated. All members of the code team thanked each other for a job well done. I was still shaken by the sight of a grieving widow who was coping with her untimely loss. 🙁

Having the opportunity to serve others in their most desperate hours is why many physicians went into this field in the first place. Not administrative duties. Not paperwork. Not litigation. Just using our medical knowledge base, procedural skills, and determination to save a patient’s life.

It’s hard work, but I wouldn’t trade it for anything.

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