re: #151 Occasional Reader

Out of curiosity; why not?

You want the coding patient to be buck naked, or close thereto, pretty quickly. Mostly because a lot of people cluster around the patient very quickly (unlike in the bogus code in the video), and need unhindered access to different parts of the body. Someone by the head will be bag ventilating, then intubating, then bagging through the tube. Someone by the chest will be doing chest compressions. Someone else near the neck will be checking for a carotid pulse during pauses in the compressions. Someone else will need to put on cardiac monitor electrodes. If a pulse comes back, someone will be checking for a blood pressure. Someone else may be trying to put in a central intravenous line, most often (during a code) a femoral line that goes in through the groin. Someone else may be trying to draw blood from somewhere else. Basically, there’s a lot going on (again, unlike in the bogus code in the video), and the last thing anyone wants is sheets, blankets, clothes, etc. in the way. Particularly a big heavy blanket that covers more than half the patient, as in this case.

Also, any serious trauma patient would get all his or her clothes removed immediately upon arriving in the emergency room, whether or not his or her heart ever stopped. ER nurses get extremely good at doing this amazingly quickly, using big scissors that are sometimes called “trauma shears.” The idea is that you need to inspect every inch of the patient for signs of traumatic injury that you might have missed. For example, you don’t notice the gunshot wound in the back until you roll the patient over. You don’t know about the bowel injury until you do the rectal exam.