Discussing Code Status Advanced Directives Serving Small Group

CODE  STATUS

Seems proper for staff to immediately contact the emergency medical team for a person who has no pulse or no breathing unless they are on Hospice.  If they are a Hospice patient we would call the hospice provider number. 

An advanced directive – living will is paper work that defines the level of medical interventions the person wants should they be without a pulse and not breathing.   This paper work is completed before an emergency and will identify a POA – power of attorney who is designated to make medical decisions when the person is pulseless and not breathing. 

Full code means the emergency medical team will start chest compressions, electric shock, and emergency medicine to temporarily get the blood moving again.

Do not resuscitate means no resuscitation measures done- and must be signed by a licensed physician.   With a DNR the medical team still provides care like curative treatment, diagnostic tests and other procedures.

Limited code means patient wants some of the interventions but not all- for example just medications- or may intubate.

Do not intubate – means no intubation to send mechanical breaths to the lungs.

As long as the patient can talk they can change their code status at any time.   Patients who come to the hospital are considered full code until they provide written (living will) instructions not to have these interventions performed in an emergency.

Upon death the 911 dispatcher typically sends the emergency medical team who confirm pulse and breathing status.  The coroner is then dispatched to the location and the chosen funeral director would be contacted.



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