How to Survive Your First Code Blue Without Crying

The Intern’s Guide to Surviving a Code Blue Without Crying

1. Step One: Pretend You Know Where the Crash Cart Is

• If you’re an intern, chances are your first Code Blue will happen when you least expect it. You’ll be standing there, minding your own business, when suddenly an alarm blares, and chaos erupts.
  
  
• Your first instinct will be to run in the opposite direction. Resist this urge.
  
  
• Instead, channel your inner calm and pretend you know exactly where the crash cart is. Bonus points if you actually do.
  
  
• If you don’t, just confidently follow the resident who does know and casually grab a random item from the cart as if it was your plan all along.
  

2. Find a Role (Any Role) and Stick to It

• The key to looking competent is assigning yourself a task—any task.
  
  
• If you’re the one closest to the patient, congratulations! You’re now in charge of checking for a pulse. (Pro tip: Make sure you check the right pulse—don’t panic and check your own.)
  
  
• If there’s already someone doing chest compressions, do not awkwardly hover over them like a lost puppy. Instead, offer to switch out in two minutes like a true professional.
  
  
• If the defibrillator is involved, don’t press random buttons unless explicitly told to do so. You do not want to be the intern who accidentally shocks the patient at the wrong moment.
  

3. Perfect the ‘Serious Doctor’ Face

• Even if your brain is screaming, keep your external expression calm.
  
  
• The best way to do this? Nod occasionally and furrow your brows in what we call the "I’m-deeply-processing-this-information" look.
  
  
• Whatever you do, don’t look terrified—it won’t help the patient, and it definitely won’t help your reputation.
  

4. Repeat Everything the Senior Says (With Confidence)

• If the attending shouts, "We need epi, one milligram IV push!" quickly echo the command in a strong, assured voice: "Epi, one milligram IV push!"
  
  
• This makes you sound involved, competent, and less likely to be mistaken for a confused bystander.
  
  
• Just make sure you’re repeating the correct orders—don’t be the intern who yells, "Give 10 mg of epi!" (that’s a very different situation.)
  

5. Know Your BLS (or at Least Look Like You Do)

• Before your first Code Blue, memorize the basics of BLS (Basic Life Support).
  
  
• If all else fails, remember this:
  
  • Start compressions (Hard. Fast. Think "Stayin’ Alive" by the Bee Gees.)
    
    
  • Give breaths (But don’t make it weird.)
    
    
  • Use the defibrillator correctly (Pads on the chest, not the abdomen, not the forehead.)
    
    
  • Look busy at all times.
    

6. Avoid Unnecessary Commentary

• Now is not the time to start asking existential questions about life and death.
  
  
• Also, do not comment on how much you love emergency medicine right in the middle of CPR—it’s not the flex you think it is.
  
  
• Definitely do not say, "Whoa, this is just like in the movies!" (This is a one-way ticket to getting kicked out of the room.)
  

7. When in Doubt, Fetch Stuff

• If you’re totally lost, your best strategy is to be the runner.
  
  
• Ask, "What do you need?" and then go get it.
  
  
• A well-timed delivery of saline, epi, or even a simple pair of gloves can make all the difference.
  
  
• Pro tip: Never return empty-handed. If you can’t find what they asked for, bring something close and say, "Here’s what I could find!" Confidence is key.
  

8. Brace for the Post-Code Breakdown

• After the chaos settles, you’ll either feel like a hero or need to lie down in a dark room.
  
  
• If the patient survives, congratulations! You’ll remember this forever.
  
  
• If not, take a deep breath. Code Blues are intense, even for seasoned doctors.
  
  
• Go find your fellow interns, swap horror stories, and remind yourself that you’re still learning.
  
  
• Then, go pretend like you weren’t just on the verge of tears and get back to work.
  

9. Survival Checklist for Your First Code Blue
✅ Locate the crash cart (or pretend you know where it is).
✅ Jump into any useful role—compressions, meds, or running.
✅ Look serious and nod appropriately.
✅ Repeat doctor’s orders confidently.
✅ Remember BLS basics and stick to them.
✅ Avoid saying anything dumb.
✅ Deliver supplies like a pro.
✅ Mentally prepare for the emotional aftermath.
✅ Tell yourself, "I survived," and move on.