Penn Medicine News Blog

October 22, 2014 // By Anna Duerr // Comments

One Size Doesn’t Fit All When it Comes to Calling Codes


FlatlineResuscitation techniques have come a long way. Just a few years ago, there were only a handful of hospitals using therapeutic temperature management (TTM), also known as therapeutic hypothermia, to treat cardiac arrest patients. Now, it’s becoming a standard tool of resuscitation, but studies show ‘cooled’ patients with good outcomes have longer code times than the traditional practice of ending resuscitation efforts after 20 minutes. So how do physicians know when to call a code?

In a paper entitled “How long is long enough, and have we done everything we should?—Ethics of calling codes,” published online last month in the Journal of Medical Ethics, senior author James N. Kirkpatrick, MD, assistant professor in the division of Cardiovascular Medicine and department of Medical Ethics and Health Policy, and others explored this very issue.

“We looked at several recent studies that suggest patients tend to do better with longer resuscitation times,” says Kirkpatrick. He says that even though standard practice is to stop resuscitative efforts after 20 minutes, “with all the new technologies we can have available, that’s probably no longer valid.”

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