Just thought I would share some details on the crap storm of a code last night
The patient was about x8h s/p their second CABG, extensive PMHX for CAD, HTN, DM, MI, PTCA(s), Lipids, ect…
the patient’s blood pressure started tanking about an hour before the code was called, started on levo, as well as lidocaine for antiarrhythmics (allergy to amiodarone), and an epi drip for cardiac output. They also had an art line to monitor pressure.
they then started throwing runs of wide complex tachycardia, which were converted into ST with defib. By the time we got up to the floor, mag/bicarb was given and the patient had been converted three times with only intermittent success. blood pressure was also in the 80/50s with the levo drip.
We shocked the pt another 7 times while we were up there. While the ER physician/intensivist/CV surgeon were discussing their options outside the room, they went into another run of VTach (the one where I was getting yelled at), at which point the ER physician decided we weren’t needed. The ER doctor also got pissed off because the same nurse who gave me crap also gave the ER doctor crap for taking over the code ( the nurse said something along the lines of “I’m running this code, but thanks for coming”)
Overall dramatic code. The CXR to me looked like they were dissecting but I only got a quick glimpse of it as we were leaving(as well as not being qualified to read them). The patient did get taken to surgery though, but I’m not sure of their outcome.