DNR

Last night was another regular busy night for us. I was carrying seven patients, six of which I did not have a good disposition on when a code blue was brought in by EMS. Now when this happens the nursing staff's gut reaction is not actively search out for the intern; however, the senior resident was involved in a sterile procedure and the attending was busy with a patient the medical student had jacked up. So I guess this was going to be my moment to shine. I had been involved in numerous codes previously while on off-service rotations, but I've never run one before. I went back to the trauma bay, gloved up, put on eye protection and waited patiently until the EMS brought the patient in. She arrived. A 91 year old lady from the nursing home with skin as pale as the snow that was on the ground outside. I could see the disappointment in everyone's faces. They all knew she was dead and were thinking this was going to be a giant waist of time. I checked the placement of the E.T. tube and resumed compressions. She was in P.E.A. on the monitor so we gave another round of epinephrine and bicarb. I let someone else take over the chest compressions and started to put in a central line. After a few rounds of compressions and medicine the respiratory therapist shouts out, "I feel a pulse!"

Everyone stops. I look down at the patient to see that her skin is nice and pink. No one could believe we got this 91 year old lady back. We actually felt kind of bad because we knew whatever piss poor quality of life this person had at the nursing home was going to be much worse after this anoxic event. The patient went in to ventricular tachycardia a few times and would require a few more rounds of amiodorone; however she eventually stabilized.

Her son arrived about five minutes later only to say that she was a DNR (do not resuscitate). I couldn't believe it. The only real wish that lady had left in life was to die, and we didn't even let her do it, but after learning of her status we told the son we would stop all heroic measures in continuing to save his mom's life. A few moments later she went in to v-tach again, and about half an hour later she passed. This time she got her wish.