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From the Heart
August 25, 2021

What We Talk About When We Talk About the Code

Author Affiliations
  • 1Icahn School of Medicine at Mount Sinai, New York, New York
JAMA Cardiol. 2021;6(11):1235-1236. doi:10.1001/jamacardio.2021.3199
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    1 Comment for this article
    How do we discuss CPR... or the Code?
    Gerry Creager, BS | Volunteer Service Organization
    I'm not a doc, but I'm also not a lay-person. I was involved in lab and clinical research at a major teaching hospital. I taught BLS, ACLS, ATLS and PALS. I've been a paramedic, on the street. I didn't do CPR on my father, as his death in at-home hospice care was expected, but I called the end, notified the police and EMS (state law requirements), and wrote the death summary.

    A better educational experience might have been to ask where and how you'd gotten your experience to draw you out, and allow you to be the teacher. />
    I've never been tired during a code because I was doing compressions. I might have a few minutes of discouragement when we lost someone, and that often felt like fatigue, but... different. There's rarely time to process what happened before the next call or code comes along. We compartmentalize and deal with this later. I still see some of my failed attempts, in a quiet time, when I least expect it, but then, I also know I did everything I could and their outcome, for one reason or another, was beyond my control.

    Codes and CPR are not just another procedure to master. They're not a foley or a chest tube, or a quick intubation for surgery. Mastering a code is something to celebrate, and then to stop, and think about what that can mean to the next person you perform that skill on (or for). Regardless of the outcome, once you've learned the nuance of the code, you'll be the better for it.

    You have honored your father well. Be proud.