First Code

vamike

vamike

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Worked my first code the other night. The pt didn't make it. How did you deal with your first code? Anxious to see the gambit of emotions that others experienced. Thank you.
 
From my own experience the first one was the hardest, dont me get me wrong it always sucks, but you need to remember that getting a save doesn't happen very often like they like to portray on tv and movies.
 
I don't remember much from my first code. I don't remember her name or anything like that. All I remember is having my sweat drip down from my face on the long transport to the hospital. I know that there was a combined total of 1 hour and 30 mins of CPR done. We got another call so I don't know if they kept working her or called her.
 
My first code was when I was 15 years old and my friend was ejected from the car we had just rolled into a ditch. I did CPR on her for 45 minutes with a fractured right Scapula, Clavicle, and Humerus. I remember the mosquitos swarming us and someone brushing them from my back as I droned on in my CPR trance. Heck, I remember everything clearly and it happened almost 30 years ago.

There was no ROSC.

After that the rest tended to be comparably easier to deal with. Even the infants.
 
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My first one was when I was a junior member at 16 years of age, I remember it well... as I was the smallest, and was able to straddle the pt doing compressions as 2 other members carried the cot ( old ferno model 30 ) outside down some steps ( talk about a power feat of strength on their part!! ).

The guy did not make it.. and I did think about it afterwards. Didn't know what to think really... in a way it was pretty kewl. In another it was sad. All in all, I accepted it and kept on cruising. Goes for all the other codes as well... peds, infants, pregnant ones, etc. Each person grieves a little different, and its a must that you find your way of dealing with it, or it will eat you up over time. You gotta deal with it, don't ignore it.
I remember all of those calls, and accept them... as they all are calls to learn from.
There is no 'wrong' emotion in situations like this due to diversity.
 
My part of the gamut:

1. I did my best
2. I was plumb tuckered out.
3. The ER folks treated us well.
4. I was too darn busy doing it right to worry about doing it wrong.
 
Yes i was plumb tuckerd out, sweated quarts on the patient, but i knew i did it right. The paramedic came to me and said i did an awesome job afterward which i was more than pleased to hear. Its not easy to work someone who is dead/dying but i did it. Is it weird to say that i now feel initiated? Maybe that im now a real emt? Thank you all for being so open on your posts.
 
vamike said:
Yes i was plumb tuckerd out, sweated quarts on the patient, but i knew i did it right. The paramedic came to me and said i did an awesome job afterward which i was more than pleased to hear. Its not easy to work someone who is dead/dying but i did it. Is it weird to say that i now feel initiated? Maybe that im now a real emt? Thank you all for being so open on your posts.
Click to expand...

No it's not weird to say that. For me it was kind of like a right of passage. When I got my first code I had to buy the crew ice cream and when I got my first fully involved structure fire I had to buy the crew ice cream. "It shows that you are really an EMT or Firefighter." that's what I was told and that's kinda how I feel about it also.
 
When you look at it...

...whether it be your first Code or the last one of your career, when you got there or while you were there someone got dead. Were you not there, that someone may not have had any chance of recovery whatsoever.

No matter what you do, you can't make dead worse.

Any critical thinking you apply after the fact is best focused on what might work better next time. There are many variables with each call. Some of them are custom-designed to make sure you fail no matter what.

A reality of the work you're called on to do is that when you're put in the position to intervene, sometimes you can be an agent of death as well as life.
 
Any critical thinking you apply after the fact is best focused on what might work better next time. There are many variables with each call. Some of them are custom-designed to make sure you fail no matter what.
Click to expand...

Couldn't put it better myself.

The first code I ran was a nursing home arrest that happened during my EMT Internship.

The Pt. was a 90+ y/o female double amputee with a long history of IDDB and ACS(no DNR).

She was last known to have a pulse ~10 minutes before we arrived. The nursing home staff didn't start CPR until we arrived.

Talking about being set up to fail is an understatement.
 
My first code was when I was a basic student, I still remember how weird it felt to feel his rib break and how difficult it was for the medics to intubate him. Honestly, I didn't feel much of anything after it, I think mostly due to the fact that the wife was just like "well, he was gonna go soon anyways". The magnitude of what had actually happened hadn't really set in.
 
I had my first code when i was 16. Pt was asystole and we brought her back to a pulse but she died later in the hospital. All in all, it was a learning experience.
 
I've run two, had ROSC on both, save on the first one...

Loved both of them. There's no high like working a code.
 
First code is always the most memorable. I was new keen and did this best compressions lol V-fib 10 shocks nil rosc, died in front of his wife and teenage kids.
 
My first code was when I was an explorer with fire dept. I was so pumped. CPR in progress, Rosc prior to getting the the ED. It was amazing! I worked in that same hospital and by pure accident saw this gentalmens wife as I was walking down the hall a year later. Come to find out he was dying of brain CA. Life is funny or crule. Like others have said there is no one way of dealing, do whatever you need. The advise around here is second to none. Keep up the hard work, it pays off.
 
I ran my first code when I was 19, working on a BLS unit with an EMR (think first responder ~ 100 hrs training), about 40 minutes from a tiny hospital, nearest ALS 2 hours, nearest real hospital the same.

Some 50 year old guy, whose wife didn't speak a whole lot of English, who'd dropped in a campsite. We put him in the truck started driving to the hospital. I was suprised at the time by just how hard it was to do CPR on a gravel road, as a sole ventilator / compressor.

Also, no one prepared me for how it's essentially impossible to manage the aiway well with just suctioning and log rolling, without having an ETT, or equivalent device. I remember the vomit smelling of Coca Cola. I didn't drink it for several years afterwards, but I don't remember being particularly distressed.

I've forgotten most of the rest. I still remember the kids, a few MI patients that were witnessed arrests and shock straight back into perfusing rhythms and varying degrees of consciousness (including one when I was faxing the 12-lead right before the patient coded, and I found out the LP12 couldn't fax and defibrillate at the same time). A few times when we coded people in front of family, especially in front of young kids, or at Christmas. But most of the memories seem to have disappeared.
 
Worked my first code less than a year ago. Ex football player in his 60's goes down in the gym. The guys in peak physical shape. We live in a rural coastal town. Air was delayed due to weather. Worked on him (CPR,AED,VENTILATIONS,Medics did their thing) for an hour an forty mins. He came an went like 5 times. Died on the flight over to the trauma center. It was kinda weird cause I knew him. Didn't affect me the way I imagined it would.
 
First code over 30 years ago......just kind of fell into the rhythm I learned in class. Didn't really think things were working well, we did CPR over 30 minutes during transport in the back of a van-type ambulance and I was dripping in sweat.

Upon transfer to ER, the physician said good job, they had a "workable" arrhythmia, but couldn't cardiovert. They called it not too soon after our arrival.
 
my first code, i was 14yrs old an riding as a Fire Explorer/First Responder. i remember the suppression had gotten there first and was still intubating when we arrived. broke a few ribs, i remember the vomit and the wife crying hysterically. enroute i was taught and successfully paced asystole (while it was still allowed in our area). eventually he was called in the ED. it was definately a learning experience, not just with the technical aspect but with how to respond emotionally and how to deal with greiving family.
 
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"Also, no one prepared me for how it's essentially impossible to manage the aiway well with just suctioning and log rolling, without having an ETT, or equivalent device. I remember the vomit smelling of Coca Cola. I didn't drink it for several years afterwards, but I don't remember being particularly distressed."

Funny how you mention the Coca-Cola. It was the only thing there was to drink in the ER after we turned care of patient over. I sucked it down after sweating so much, but it seemed to smell and taste like puke. Ill never drink another Coke product. :wacko:
 
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