Code Blue

If you've ever spent any time in a hospital, you become accustomed to the regular calls over the intercom. They range from the almost weekly Code Reds, that trigger the smoke alarm every time someone makes popcorn in the communal kitchen- to bomb threats, missing patients, violent situations and more.

Each situation is colour coded to alert the appropriate staff into action. Code Blue is one of the most serious medical codes, alerting an entire response team into action. Code Blue denotes cardiac or respiratory arrest. Translation: someone's heart has stopped, they have stopped breathing or are in imminent danger of these.

Every time I hear a Code Blue called, I hold my breath and wait until the voice on the intercom comes back on to call out "Code Blue All Clear". Never in a million years did I think we would be the source of a Code Blue.

Unfortunately, on February 13 Rémi went into respiratory distress and prompted a Code Blue situation. His replogle tube stopped functioning properly and he aspirated on his secretions. Once the nurse hit the emergency button at the head of his bed, in what felt like the absolute longest seconds of my life, an entire team of medical professionals was at his bedside working to stabilize his airway. Somewhere within those chaotic moments I had to make one of the worst phone calls to David. I think all I said was "run". With that one word, he knew something was terribly wrong.

By the time David arrived, they had stabilized Rémi with a machine and oxygen to help him breath. He stayed on oxygen support for another day since the aspiration had caused pneumonia to develop on his lungs. On the 15th, he was weaned off of support fully only to cause another Code Blue mere hours after.

This time, we were taken to CCU (critical care unit) for respiratory support and monitoring. We needed to get to the bottom of what caused these two critical events. A team assembled to determine our next steps and hypothesize about the underlying cause.

1) Was this actually a cardiac event triggered by the unclosed valves in his newborn heart?

2) Did his original surgery site get damaged and was his tracheal esophageal fistula back?

3) Did he have an additional fistula that was undiagnosed when he was born?

To get to the bottom of these questions, we needed more tests. A bronchioscope was ordered, and quickly taken away as an option. There was too much risk of damaging his airway with the scope and they needed another way to see inside to his surgery site. In addition, a repeat echocardiogram was ordered to determine if his heart was the underlying cause (see article on PDA and PFO).

Luckily, Rémi has made a full recovery from both of his respiratory events. There are still some unknowns, but we are hopeful that we can get to the bottom of it soon.

Until then, Code Blue All Clear.