Call a Code Blue!- A brief education on a medical emergency

So who doesn’t love a good medical show? Nowadays the shows that are medical related are a dime a dozen. From House, to Grey’s Anatomy, to the never forgotten ER, these shows give us a peak in the lives of health professionals. What I want to talk about though is the infamous code blue. You guys know that moment in the show where you see the health staff yelling “code blue, code blue”. Then you see the patient on their bed pale, unresponsive, and they look like they literally have no life left in them.

In this article I will explain the basics of what is going on in the person especially their heart and what the medical staff is basically trying to do. This will be nothing to in depth just a basic education, because to be honest what is exciting to watch in TV is actually very scary experience in person especially if it is your own family member.

The heart which I like to call the “Real Muscle” of the body is responsible for ejecting blood to your major vital organs of your body. Without your heart outputting a sufficient amount of oxygenated blood, your organs suffer and basically don’t get their needed oxygen. I know all you guys have held your breath before and what you are basically doing? You are depriving the body of oxygen which your body needs and ultimately building up carbon dioxide which accumulates.

So which leads me to my next point, your heart rhythm is basically an electrical conductive system. Your heart has pacemakers to help set the rhythm and the rate at which it pumps. The main pacemaker of the heart is your SA node, but just in case that one fails there are backup mechanisms. With that said those backup mechanisms aren’t as efficient as the SA node. Your heart basically is full of fail safe pacemakers just in case anything goes wrong, but they may not pump at a proper rate or put your heart in a proper rhythm. When your heart is pumping in its proper rhythm it is called Normal Sinus Rhythm which pretty means Life is GOOD! You are getting proper cardiac output and your heart isn’t working too little or too hard, it is going just right.

Two of the main deadly rhythms that are mostly seen in a code blue situation are Ventricular Fibrillation and Ventricular Tachycardia that is pulseless. These two heart rhythms are so erratic and so inefficient that your basically getting no cardiac output. The ventricles of the heart which are parts of the heart have the ability to be pacemakers but are horrible in doing so. So what you get is a patient with an abnormal heart rhythm with basically no cardiac output. Especially in Ventricular Fibrillation the heart is basically just quivering with no real actual efficient pump to eject the blood.

In the hospital when we notice this we call a “code blue”. Our basic goal here to either shock the heart back to a normal rhythm to help re-sustain some decent cardiac output. The quicker we are to react as health care professionals of course the better the outcome. Every second we don’t do something we are depriving the entire body of oxygenated blood. We use the defibrillator which will basically deliver an unsynchroized shock or electrical energy. What happens when the shock is delivered it trying to depolarize which basically means we are trying to reset the rhythm of the heart, in doing so we would hope the SA node would kick back in and reset the heart to a normal sinus rhythm.

I can go further in depth on this article but it would take me another page . I just wanted to give a basic brief summary. Once the heart rhythm is back there is many other things that can happen or must be done. For instance, trying to sustain a normal blood pressure or trying to raise the heart rate. I will save that for another day. In the meantime when your out in a public place and see the little box with the letters AED. That stands for Automated External Defibrilator and is used just in case someone needs it in a public setting.

Jed Jularbal, BSN, RN
The Methodist Hospital- Houston Texas

Email: jrjularb@gmail.com