Code status discussion
Formal Definition
A conversation between the treating physician and the patient (or surrogate) to determine the patient's preferences for cardiopulmonary resuscitation (CPR) and intubation in the event of cardiac or respiratory arrest; includes clarification of what CPR actually entails, the patient's goals of care, and documentation of the agreed-upon status as a medical order (full code, DNR, DNI, comfort care).
How It's Used on the Ward
Code status or what code status does the patient want? or code discussion — asking whether a patient wants to be resuscitated if their heart stops or they stop breathing.
Example
"Discussing code status with 84-year-old with end-stage CHF: "If your heart were to stop beating or you were to stop breathing, would you want us to do chest compressions, use a breathing tube, or try to restart your heart with paddles? Some patients feel the chances are too low and the suffering too high. Others want everything done. What matters most to you?""
Clinical Context
CPR success rate: overall ~12% survival to discharge; for hospitalized patients with non-cardiac diagnoses, <5%. Patients overestimate benefits — studies show most believe CPR survival is 50-80%. Code status does not mean "do not treat" — DNR/DNI patients still receive aggressive treatment up to the point of arrest. Types: Full code, DNR (no chest compressions, no defibrillation), DNI (no intubation, but chest compressions/defibrillation OK), comfort care (focus on symptom relief only, no ICU, no intubation, no CPR). Timing: discuss early in hospitalization, revisit when clinical trajectory changes, document clearly in the note and in the order.