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Correct Creative Writing: How to Actually Work a Code (Ish - This Isn't Med School).

Updated: Jul 6, 2020

Want someone to die in your book? Don't know how to do it? Here's a simplified version of how you work a code prehospital.

So, someone dies. Is it a medical issue that strikes? Or a crazy trauma that brings someone to the brink of death... then the amazing paramedics come in to save the day?

It happens. In a lot of shows and book and in movies. And the characters always seem to shock a flatline (see you DON'T SHOCK ASYSTOLE). So, if you want to run a code (cardiac arrest) as accurately as possible, here are some tips.

Tip 1: Compressions are key.

- EMS and health care are trained to get on compressions as fast as possible. Compressions don't stop in a code. If a rescuer gets tired, another switches them out as fast as possible. It takes a lot of pressure to keep blood flowing in the body, and even more to get it to the brain. If theres a pause in compressions, you have to rebuild that pressure in the body. So no pause in compressions.

- Fun fact, we always break ribs. If you're not breaking ribs, you're not doing compressions properly. They crunch.

- Extra fun fact, usually the breaking of the ribs makes what's called a "tension pneumothorax" (look it up, it's cool). That means that someone gets to poke the chest with a giant needle to make the air even out in the chest cavity. Pretty much it's a "collapsed lung" that people can fix prehospital.

Tip 2: Paramedics can intubate.

- So, they stop compressions for the shortest amount of time possible. The person leading the call intubates, then compressions resume.

- Compressions are more important than the airway (unless it's a choking), so if you can't intubate pre-hospital, you don't. Just doing compressions is just fine (this is a life tip, if you don't want to breath for people, don't).

Tip 3: Check for a pulse every couple minutes

Tip 4: If it's a trauma, solve the major bleed first

- Compressions don't do anything if blood is spurting out of a chopped off leg stump.

Tip 5: Epinephrine

- So, if you're guy is dead as a doornail, the last ditch is to start an IV line (or an intraosseous line- you drill into the shin or arm bone, it's uber cool). From there, you push epi every 3-5 minutes and follow it with a flush of saline.

- Check for a pulse a lot.

Tip 6: Shock

- You shock if the rhythm is v-fib or v-tach. If you have an AED, every time you press ANALYZE, if it's in a shockeable rhythm, it will say SHOCK ADVISED. If it's anything other that v-fib or v-tach, it will say NO SHOCK ADVISED. Then you just keep on trucking with CPR.

There is a lot of different ways to kill people (in a book, obviously). But if you want them saved in an accurate way, read the ACLS protocol.

Happy killing (and saving!).

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