Every hospital I've ever worked, volunteered or studied in has had a totally different set of emergency codes. Usually there are colors (e.g code blue, code red, code brown) mixed with other random codes that inexplicably ruin the theme (e.g. code triage, code zebra). You'd think some of the well known ones like code blue would stay consistent, but some hospitals just need to be different, so you have to relearn them at every facility you find yourself at.
My current hospital has two codes that I've been told to know: code 66 and code 99. Why you would pick the only superimposable numbers is beyond me. In any case, code 66 refers to a psychiatric emergency while a code 99 refers to a medical emergency. Exactly a week ago, I saw my first (false alarm) code 99. After the code was called over the campus-wide intercom, an ambulance, paramedics and eventually two doctors showed up to make sure the patient was alright medically (he was).
Today I saw my first code 66. A patient was not responding to the nurses' calls to calm down and he would not let them give him a sedating medication. Once the code was called, myself and all the psychiatric staff rushed out of the nearby offices to the area the patient was in, in case we were needed before the real help arrived. And boy did it arrive. A nurse and doctor from another floor as well as six fully armed police officers arrived to help subdue the patient until we could administer the sedative. Given the modest danger of being on a locked ward with some agitated, very physically powerful patients, it's nice to know that a whole lot of help is just a call away.
TIL: When giving a sedative in an emergency situation as mentioned above, remember to be patient and wait for the medication to take effect. It can be easy to succumbed to panicky pressure to repeatedly inject the patient until you see results, but you must remember that these drugs take time to take effect. Doubling or tripling the dose can quickly over-correct the agitation and even kill the patient.
B52 or 5-2-50 is a common concoction of medications used at an emergency sedative and antipsychotic. in each of the two names, the 5 and 2 represent 5 mg of haldol and 2 mg of lorazepam, respectively. The B and 50 refer to 50 mg of diphenhydramine, aka Benadryl.
In 2004, the FDA issued a black box warning on antidepressants that warned of an increased risk of suicide in children. Though it seems counterintuitive, the data showed that for certain patients at a specific point in their treatment, they go from being suicidal and apathetic, to still being suicidal but having enough energy to commit the act. If the kids make it through this period, they're in the clear, but the FDA thought parents should be warned. In 2005, more children committed suicide than any year on record - not because of the antidepressants, but because a large percentage parents misunderstood the tiny risk and refused to let their children take antidepressants at all.
The three classic treatments for refractory suicidal ideation are clozapine, lithium, and electroconvulsive therapy (ECT). ECT has gained a bad stigma, for good reason, as it was one of the treatments of choice during the dark ages of mid-20th century psychiatry. Though, most of the old uses had little supporting evidence, a few conditions actually respond very well to shock therapy. The big difference today is that we actually use anesthetics so that the brain is effectively given a seizure as a sort of electrical reset without disturbing the patient in any conscious way.
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