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Inside Story
August 2016

Partial Codes—When “Less” May Not Be “More”

Author Affiliations
  • 1Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Transitional and Supportive Care, Wake Forest School of Medicine, Winston-Salem, North Carolina
JAMA Intern Med. 2016;176(8):1057-1058. doi:10.1001/jamainternmed.2016.2522

“Is he a code or not?” shouted the cardiology fellow.

“Partial code, no intubation,” answered the nurse. Faces frowned and breaths were sighed. Leonard was a 77-year-old man with widely metastatic colon cancer. Nearly everyone agreed that it would be better to forgo resuscitation and let him die.

“Okay, bag him with the mask, get a central line started, and continue compressions.”

Thirty minutes later, spontaneous respirations and a heart rhythm had been restored. He was transferred to the intensive care unit (ICU) for further care; however, concern arose as to the possibility of anoxic encephalopathy. Soon his family arrived, and a family meeting was hastily arranged.

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