So I’ve been in too many codes where it is complete chaos. Sometimes the difficulty is figuring out what’s going on. Most often though, it is other problems. Someone doesn’t know where the extra epi is, no one can get a line, the compressions are not good enough, someone can’t set up the infusion pump, etc. Obviously this does nothing good for the patient’s prognosis.
Recently though, I had the pleasure of being in a code that went swimmingly well. The compressions were good, the meds went in quickly, the pump and monitor were fine and the defibrillator pads were hooked up in five seconds! Hallelujah!
The other thing is that this person actually responded to the treatments.
However, as too often happens, even when things go right they also go wrong. Even well-run codes don’t necessarily work and patients die. As they say sometimes, “shit just happens and then you die”.

Me: “So, you were lightheaded and dizzy and then you worried that your blood pressure might be high so you took two extra doses of your blood pressure medication?”

Mr Hypoperfusion: “Yeah”

Me: “Let me guess. And then you passed out?”

Mr Hypoperfusion: “Yeah, I didn’t see that coming”

One thing I truly hate is when clinically something seems like a slam dunk but then some test proves you wrong. Many cases are debatable but some just read like Harrison’s – i.e. the patient’s clinical picture is right put of a text book. Still, sometimes for CYA reasons you have to do a test to completely rule it out (like because the pt had several risk factors) or because they demand it and you are just not up for an argument that day.
And then would you believe it, you’re wrong! The pt rules in! Perfect example, a woman with mild non-exertional chest pain, worse with rotation of the neck or when she presses on the area, and no SOB or other symptoms. Normal EKG. You do enzymes because she has a strong family history and is post menopausal and BAM! They’re positive. Very positive. Lucky for both of you but not lucky for clinical medicine.