My whole hospital system (Providence-St Joseph) will be eliminating partial code status over the next year. They have several reasons-
Patient/family would only choose partial code if they don’t fully understand how a code works and the importance of each aspect. This is seen as a need for providers to provide better education, so that they can make proper informed decisions.
Partial codes practically guarantee negative outcomes. Even if you got ROSC, if the patient didn’t get compressions or intubation, they will have hypoxic brain injury.
Partial codes create confusion among the care team and uncertainty of how to react in a code situation.
I agree with all the above, and think this is a good thing. I especially hope (but am skeptical) that it will create a culture of better education about what a code entails and what the aftermath looks like, as well as more in depth goals of care conversations.
My main concern is that more people who probably should be no-code will end up full code due to patient/family wanting to “do something.” We all know the futility of just pushing meds and bagging a patient without compressions/shocks/intubation. But that option is honestly much more gentle than full coding them.
I’m interested to hear your thoughts and experiences with this.
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