Code Blue: Cardiac arrest

Oh Danny boy, the pipes, the pipes are calling

From glen to glen, and down the mountain side

The summer's gone, and all the flowers are dying

'Tis you, 'tis you must go and I must bide.

Danny Boy

A 94 year old admitted with chest pain.

0206:  Called to room because patient was feeling nauseated.  Patient found to be diaphoretic,  nauseated, and anxious.   Holding chest.   Became unresponsive and pulseless.   Code Blue called.


0210:  CPR initiated.   Placed on monitor.   Normal saline started.

0211:  Defibrillated at 200 joules.   Post-shock rhythm ventricular tachycardia.   CPR resumed

0213:   Epinephrine 1mg IV given.   CPR in progress.   Positive pressure ventilations adequate.

0215:  Defribrillated 300 joules.    CPR resumed.    Ventilations becoming more difficult.  Abdomen distended.  Attempted NG insertion x 2.   Vomited large amount of emesis.   Aspirated.  Suctioned orally and via nasopharynx.  Large amount of yellow emesis returned.

0218:   Epinephrine 1mg IV given.   CPR in progress.   Abdomen decompressed.  No further vomiting.   Coarse rhonchi.  Ventilations difficult.   Intubated with 7.5 oral ET tube.   Decreased breath sounds on the left.  Tube pulled back.   Bilateral breath sounds present.   End tidal CO2 with positive color changes.   Suctioning large amount of gastric contents via ET tube.  CXR done.

0220  Rhythm change to ventricular fibrillation.  Defibrillated with 360 joules.   CPR in progress.   Ventilations adequate.

0224:   Rhythm change to asystole.  Epinephrine 1mg IV given.   CPR in progress.   Continuing to suction gastric contents via ET tube.

Accelerated idioventricular

0228:   CPR in progress.  Rhythm check:  agonal rhythm.   Epinephrine 1mg IV given.  Ventilations adequate.

0231:   CPR in progress.   Ventilations adequate.   Normal saline bolus in progress.   Epinephrine 1mg IV given.

Agonal rhythm

0235:   Code ended.

Agonal rhythm

0240:

Asystole