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As an ICU attending, I’ve led hundreds of codes, & as a sim instructor, I designed a sim focused on the intangibles.

Here are 10 essential elements of code & rapid response leadership (in no particular order) that are not taught enough yet help control the chaos.

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1/ Be a calm & clear leader

ACLS 101.

This isn’t about ego. It’s about your patient.

Don’t be mean or yell.

Calmly stand at foot of the bed, raise your hand, & say, “I’m going to run this.”

Reset the room.

Attendings, support your trainees, “I’m right here. You got this.”
2/ Turn down the noise

Chaos loves 20 people in a cramped hospital room yelling at each other.

Ask everyone to try to be quieter & for non-essential personnel to step out.

In our MICU, codes are quiet. We strive to control the chaos like an orchestra.
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