running codes

[Eidee]

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ok so i'm about a third into my intern year, and being off service, i know that if there's a code most people there might turn to me b/c i'm the "er resident..and that we do these all the time"... yea, i know i should know acls inside and out but i've been off service alot and haven't really been involved in many codes to get any practice. anyone know of any website/computer programs that can give you some practice? I don't wanna be pulling out a book in the middle of code while a patient is crashing

 

[roja]

When I was an intern, I carried a great little pocket book. (i'll havfe to find it.. its done by an RN and is waterproof, spiral bound, etc) I read through my protocols very frequently so that I didn't have to pull out my book. Its algorithms. Its really memorization. (in terms of justusing acls.) The subtleties, you will learn later.

 

[igcgnerd]

The ems acls field guide is very similar you can buy it at most barnes and noble or borders in the medical reference section
it has all the acls algorithyms that you can read through when u have the time an eventualy they will become second nature or if they dont just hope a senior resident or attending shows for back up lol😀

 

[Apollyon]

When I was an intern, I carried a great little pocket book. (i'll havfe to find it.. its done by an RN and is waterproof, spiral bound, etc) I read through my protocols very frequently so that I didn't have to pull out my book. Its algorithms. Its really memorization. (in terms of just using acls.) The subtleties, you will learn later.

Agree 100% with roja. What you need is just to look confident. When I was an intern in my prelim IM year, I ran a code (including tubing the patient) on the floor (with my PGY2 senior there), until the EM resident on the code pager got there; the EM resident said that he "would work with me anytime" (even though he didn't have to do anything when he got there, 'cause I had taken the one procedure!).

 

[wook]

When I was an intern, I carried a great little pocket book. (i'll havfe to find it.. its done by an RN and is waterproof, spiral bound, etc) I read through my protocols very frequently so that I didn't have to pull out my book. Its algorithms. Its really memorization. (in terms of justusing acls.) The subtleties, you will learn later.

I spend about 5-10 minutes before each EM shift reviewing the ACLS protocols. It has helped tremendously.


Wook

 

[SoCuteMD]

ok so i'm about a third into my intern year, and being off service, i know that if there's a code most people there might turn to me b/c i'm the "er resident..and that we do these all the time"... yea, i know i should know acls inside and out but i've been off service alot and haven't really been involved in many codes to get any practice. anyone know of any website/computer programs that can give you some practice? I don't wanna be pulling out a book in the middle of code while a patient is crashing

You could always just print out the algorithms, shrink them to 1/4 size, and laminate them. A couple cards each for ACLS and PALS - fewer if you double-side them.

 

[Aloha Kid]

Top Ways to Avoid Running the Code.

1. Get at the head of the bed and look busy trying to intubate.

2. Look at the other resident and say, "This is too easy for me, you run it, you need the experience anyway."

3. Pretend you're getting presyncopal and pass out on the floor.

4. Say, "I'll check the code status," and walk out of the room.

5. When the code pager rings, run into the room only after another resident has and make sure your behind the other resident at all times so the nurses look at him/her instead of you.

6. Jump on the patient and squeeze them tight saying, "Why grandma? why you?"

7. Ask for 1000 mEq Potassium STAT IV push and watch as all the nurses ignore you and turn to someone else for instruction.

8. Run into the code late and say, "Ohh, Duh! its room 506, I was at 406!"

 

[ERMudPhud]

Codes really shouldn't be that scary. Once you finish with ABC's, which really shouldn't be that hard for those of us in EM, you really just need to know asystole/PEA and the Vfib algorithm. Those two are awfully simple. Everything else ought to be stabel enough you can take a few seconds to pull out your reference cards, take a deep breath, discuss thing for a second, and then decide what to do.

 

[waterski232002]

After ABC's... just ask for Epi and Atropine every 3 min... shock v-fib/tach. The only other drug you really need is 300mg amiodarone if your first shock doesn't cardiovert them.

That will get your through the first 10 min of almost any code.

 

[em4me]

Top Ways to Avoid Running the Code.

1. Get at the head of the bed and look busy trying to intubate.

2. Look at the other resident and say, "This is too easy for me, you run it, you need the experience anyway."

3. Pretend you're getting presyncopal and pass out on the floor.

4. Say, "I'll check the code status," and walk out of the room.

5. When the code pager rings, run into the room only after another resident has and make sure your behind the other resident at all times so the nurses look at him/her instead of you.

6. Jump on the patient and squeeze them tight saying, "Why grandma? why you?"

7. Ask for 1000 mEq Potassium STAT IV push and watch as all the nurses ignore you and turn to someone else for instruction.

8. Run into the code late and say, "Ohh, Duh! its room 506, I was at 406!"

I'm going to laminate this (and maybe the ACLS stuff too) and put this in my pocket.