How to run a code

Cardiac arrest. It seems so easy. Just follow the algorithm on the reference card, and all cardiac arrest issues will be solved. The truth is that codes can be messy, chaotic and scattered. On this episode of ERcast, we hear from the RAGE podcast  experts on how to take control of the room and run an effective resuscitation.

The medicine isn’t always the hard part. Being an effective leader, communicating well,  and making things happen are often the bigger challenges. And speaking of Making things happen, click that link for one of the greatest medical lectures. Ever.

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Bonus section: Adenosine vs Verapamil Articles

Adenosine versus Verapamil for termination of SVT (AVNRT)

Comparison of adenosine and verapamil for termination of paroxysmal junctional tachycardia

Adenosine versus verapamil in the treatment of supraventricular tachycardia: A randomized double-crossover trial

Comparative clinical and electrophysiologic effects of adenosine and verapamil on termination of paroxysmal supraventricular tachycardia.

Contemporary management of paroxysmal supraventricular tachycardia.





  1. andrewrcoggins

    The Crisis Resource Management Skills needed in Cardiac Arrest really outweigh any knowledge content you can learn from a book. Karel’s comments on managing the pre-hospital environment and Cliff’s thoughts on team management are especially useful to reflect on… One useful tip is try to create a culture of debriefing your codes -- it does take a few minutes but it can really help progress your “human factors” skills

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  3. Ethan Levine

    Hey, I’m a PA student and was just recently on my ER rotation. The situation was a 64 year old male who had went into sudden cardiac arrest at home. The medic was unable to tube the patient in the field. Multiple respiratory therapists were also unable to tube the patient in the code room. The team leader (attending in this case) was finally able to intubate the patient. The same team leader was also used as the last resort to place a femoral line in approx 5-7 minutes later. I was just curious as to what your take is on what the team leader should do when he/she has to remove themselves from the foot of the bed to take over a procedure? Should the team leader appoint a fellow rescusitating team member to take over as leader? Thanks a lot for your response!

    I just started to listen to your podcasts and I love the company while I’m driving. Thanks for all the wonderful info!


    1. Post
      Rob Orman

      Hey Ethan, It all depends on the available number of operators and who is capable of running the code. In some EDs, this is possible and in others it is not. What you describe, turning over the cognitive aspect of running the code, is a good goal, but not what usually happens. It can be hard to break the momentum of code leader, even when the code leader becomes a hands on technician.

Awesome article, I know - please share your erudite thoughts...