...which leads to the worst nonsense ever when you have to respond to floor codes as an ICU resident and you don't know anyone's name, the floor nurses don't know how to run a code, and the surgery residents try to start running things.
not that this ever happens, hahaaaa...
in "real life", in my case community practice, codes are usually pretty drama free. you know everyone's name, you're the only doc unless a partner who's also on comes by. the nurses know what to do. one charts, one does meds, and there are 1-2 others doing IV's, helping you, etc. an RT is there to get your airway things and bag. as far as helping out anther doc - i have at times done a cardiac US for a partner or helped pull things up in the EMR, etc. (usually medics have done 80% of the ACLS protocol anyway...)
When a Code Turns Into a Chaotic Goat Rodeo
I agree, La Gringa. In the community setting the players are usually very well known. You walk into the room and it's expected you will run the code, because that last 50 codes you walked into, you captained. Having someone else competent come in and take over the code, ie, cards, ICU or trauma attending would actually be a blessing (been there, done that) and would free you up to do other things, see the next code, or clear out a constipated ED in need of urgent catharsis. Generally this doesn't happen though, because other docs have their own work to do and are more than happy to let you earn your paycheck. Other attendings generally aren't going to have any desire to come to your ED to take over your codes any more than you will have any desire to run to the gyn floor to help out with pelvics or run to the ICU to help out with death pronunciations. This is opposed to a couple of interns jockying over rank. Don't worry, you'll get more than enough "codes."
In an academic setting, where no one knows who's who, or who's capable of what, including sometimes those trying to captain the ship themselves, is where things can quickly descend into a stage 4 goat rodeo.
In such a setting, walk in the room and ask loudly, "Who's running this code?" If someone (competent appearing) claims to be, stand back, let them have at it and help out with lines, CPR, bagging, and other supporting tasks. If no one steps up (and you feel ready to step up) say loudly, "I am," and run the code like you know what you are doing. Ideally that means much delegating and not getting lost yourself in every little menial task. Don't try to run the code
and do all of the procedures, too. Otherwise you lose the big picture and the ABCs can get scrambled.
You're doing good out there. Keep up the good work.
(I do sincerely apologize if any goats, goat herders, goat advocates, goats-milk salesmen, goat jockeys, or members of the goat rodeo industry were offended by this post.)
