Yesterday I attended my first Code Blue in which we were unable to resuscitate the patient.
This specific patient came into the ER the day before with complaints of hypertension (above usual) and pedal edema. He had ESRF (End stage renal failure) and got dialysis twice a week. The ER physician wanted to admit him but his nephrologist decided he didn’t need to be admitted to the hospital (I’m not sure why)
Apparently, the next day when he came for dialysis, they chose to admit him (I didn’t manage to hear what his admitting diagnosis was during the chaos of the code)
Before he coded he stood up and went to the bathroom walked around the unit, and as he was sitting back down in his bed, he essentially died.
By the time the ER physician and I made it up to the floor, he was in PEA (pulseless electrical activity)
We did CPR for a while, pushed some x4 epi and x4 atropine and x1 of bicarb (not in that order). Nothing seemed to be working so we were about to call it after 30 minutes, but then his nephrologist showed up. At this point the ER physician and I decided to leave since the patient’s primary physician was there and there didn’t seem like there was much more we could do.
We got a call about an hour later that they decided to call it.
It was a pretty crazy night to say the least.
The reasons for why he could have died are extensive, I think. The most likely I would think would be hyperkalemia or acidosis. Maybe even pulmonary edema but I doubt it.