Hospital Code Teams

[waterski232002]

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Are there any EM residency programs which incorporate having EM residents rotate on an in-hospital code team? If so... which programs have this?

 

[docB]

At UC Davis the "code team" is the ICU team. When you rotate on ICU you are the code team.

 

[Apollyon]

At Duke, the senior on the acute side (whether it's an EM 2 or 3, or IM 2 or 3) takes the code pager, and, when it goes off, the resident, the RT, the charge nurse, and an aide go; this team covers all adults, on the first floor or lower. The resident goes it alone; upstairs codes, and peds codes everywhere, are handled by other teams. However, in the MICU or PICU (and in the SICU across the street at the VA), you will carry the code pager, so you get your feet wet everywhere.

 

[DrMom]

At UC Davis the "code team" is the ICU team. When you rotate on ICU you are the code team.

That's how it works at Tulsa Regional Medical Center, too. I'm sure you all were at the edge of your seats wondering about the workings of TRMC. 😎

 

[NateatUC]

At UC Davis the "code team" is the ICU team. When you rotate on ICU you are the code team.

Its somewhat like this at Cincinnati too, except that seemingly ALL off the medicine residents (ICU or not) carry code pagers and come running. I guess they want whoever is covering that team's patients there for the code. Interesting situation ensues when someone goes syncopal in the lobby.

 

[roja]

At UC Davis the "code team" is the ICU team. When you rotate on ICU you are the code team.

ditto where we are. Although the ED covers 'radiology'

 

[DocWagner]

EM covers the entire first floor and radiology at each hospital. During ICU months the ICU resident (EM resident) covers the entire hospital (small rural hospital).

 

[docB]

ditto where we are. Although the ED covers 'radiology'

Good point. At UCD we actually did cover radiology and one inpt ward just because we could get there first.

 

[NinerNiner999]

Here at Hopkins code teams are floor-dependent. In the ED, each resident is assigned to either medical or trauma code teams (and given a specific part such as airway or circulation, etc). On the floors, an anesthesia resident is paged for airway management, medicine resident runs the code, and surgery covers lines and access. Three people with rotating schedules - in short code call is about once every three weeks...

 

[Seaglass]

Why would you want to go to more codes? I can't think of a residency program that doesn't have enough resuscitation going on in the ED.

 

[Annette]

My program is flooded with people responding to codes. The ICU sr and intern, ICU attending, CCU sr and intern, 2 medicine team seniors, and a gen surg sr and intern. The ED people pop in as well when they are the closest (such as in radiology). We also get 2 CCU nurses and one ICU nurse, and 2 respiratory/ekg. Then there are the floor nurses and the nursing supervisor. Oh, and then the chaplin. Eventually the transports come as well. . .

 

[beyond all hope]

As a tern I loved responding to codes, no matter what service I was on. I would show up, and if I was the first one there I'd start running the code. Good experience for a tern, I think.

I still show up for codes if I've got nothing better to do. Sick, hungh? Occasionally I get a procedure in there: pericardiocentesis, chest tube, ETT, cutdown, central line, etc. Better than ICU notes.

 

[waterski232002]

Why would you want to go to more codes? I can't think of a residency program that doesn't have enough resuscitation going on in the ED.

Resuscitations and codes are not the same thing... plus I think there's added value in learning how to manage in-hospital codes vs. the drop-offs in the ED. It's not all that often that patients actually code in the ED; excluding the patients who are coding and CPR is on-going en route.

 

[Scrubbs]

In my program - Drexel - we run all codes in the hospital when we are in the unit. Med/Surg respond, but the unit residents are the code leaders. And, since we fully staff the ICU (no other services on our team), we get a lot of experience in this department.

 

[Whisker Barrel Cortex]

Thank god somebody comes to radiology to run the codes. You sure as hell don't want me doing it (although I am ACLS certified). I got very little experience in codes as an intern due to what I consider a "white cloud." When I was on call (q4d for 7 months of the year) as an intern, there was exactly 1 actual code (a couple of false alarms). Other interns had 1-3 per call on average. Patients stayed alive when I was on.

 

[Sessamoid]

Thank god somebody comes to radiology to run the codes. You sure as hell don't want me doing it (although I am ACLS certified). I got very little experience in codes as an intern due to what I consider a "white cloud." When I was on call (q4d for 7 months of the year) as an intern, there was exactly 1 actual code (a couple of false alarms). Other interns had 1-3 per call on average. Patients stayed alive when I was on.

Damn, with that kind of record you should have become a hospitalist! 🙂