Remember the man I mentioned about 2 weeks ago who had swerved to avoid a deer and ended up hitting a tree? A week later, he came to the hospital with encephalitis that we initially thought was related to an undiagnosed skull fracture. Later, the neurologists decided that it was coincidental, and that his encephalitis was more likely coincidental. Today he died. He coded on the floor…The neurologist, radiologist, IV team were overhead paged to a floor “emergency”. After hearing all three in succession, they finally overhead paged the Unit attending, who chuckeled at hearing his name…Imagine…if you were in the hospital and were in a condition that required Emergency X-rays, a neurologist STAT, and the IV team stat…wouldn’t you also want a critical care specialist there? Well, they brought him over to the unit in the midst of CPR. His condition continued to deteriorate as my colleagues ran through each branch of the ACLS (Advanced Cardiac Life Support) algorithm in turn. Last effort measures include needle decompression of the chest and pericardiocentesis…usually when the patient as been asystolic (without a heart beat) for some time and no other measures are working. Needles were passed into each lung field in the hope that a compressed lung might be decompressed, but it didn’t work. The code was called, (“Time of death, etc…”) and we continued on with our daily work without missing a stride.