Full Code Status is a medical order that guides healthcare providers on the level of intervention required if a patient’s heart or breathing stops. This status is the default for most patients admitted to a healthcare facility, signifying a mandate to attempt all available life-sustaining measures. When a patient is designated “Full Code,” it means they have consented to the maximum extent of medical intervention in the event of a cardiopulmonary arrest. The term directs the medical team to mobilize immediately and use every tool at their disposal to restore the patient’s vital functions.
The Specific Medical Actions Authorized
A Full Code status initiates a rapid, aggressive response that encompasses several high-acuity medical procedures. At its core is Cardiopulmonary Resuscitation (CPR), which involves external chest compressions to manually circulate blood to the brain and other organs. Rescuers also provide artificial ventilation to supply oxygen, often by placing a breathing tube into the windpipe, a process called intubation. The response also includes advanced cardiac life support measures. This involves the use of a defibrillator, which delivers an electrical shock across the chest to reset the heart’s rhythm if an electrical malfunction is present. Emergency medications are administered intravenously to support heart function and blood pressure. For instance, the vasoconstrictor epinephrine is given during the resuscitation effort. Antiarrhythmic drugs may also be administered to stabilize the heart’s electrical activity if the initial shocks are unsuccessful.
Contrasting Full Code with Other Directives
The concept of Full Code status is best understood in contrast to specific limitations a patient may place on their care. The most common alternative is a Do Not Resuscitate (DNR) order, which instructs physicians not to initiate CPR if the patient’s heart or breathing stops. A patient with a DNR order receives all other medical care, but the aggressive interventions of CPR are withheld. Other limitations include a Do Not Intubate (DNI) order. A DNI status allows for CPR and other resuscitation efforts but specifically prohibits placing a breathing tube and connecting the patient to a mechanical ventilator. Full Code status means the patient has not placed any such limitations, authorizing the medical team to use the entire range of resuscitation techniques.
Making and Documenting the Decision
A patient’s code status is often discussed upon admission to the hospital or when a change in health status occurs. If a patient is unable to communicate their wishes, Full Code is the status presumed by the healthcare system unless a previous instruction exists. The decision to choose or decline Full Code status is made in consultation with a physician, who explains the potential benefits and risks of these interventions. Formalizing this choice is done through specific legal documents known as Advance Directives.
Advance Directives
A Living Will can specify the patient’s wishes regarding life-sustaining treatment, including their code status. A Power of Attorney for Healthcare designates a trusted person to make medical decisions if the patient loses the capacity to do so. The final code status is recorded as a formal medical order, such as a Physician’s Orders for Life-Sustaining Treatment (POLST) form.