cards · checks stay on this phone
Conversations — code status · SPIKES · debrief
26 values across 4 cards. Rows check off.
Debrief 8 Anyone on the team can call for a debrief — five focused minutes, now.
We start from the assumption that everyone here is intelligent, capable, cares about doing their best, and wants to improve.
Review the case timeline together — read the timestamps aloud as the shared record.
Each role saw a different case. Let everyone add to the shared picture before anyone evaluates anything.
DELTA — what inhibited us?
PLUS — what do we take away?
Pick one or two deltas at most to act on, name who owns each, and stop there.
SOURCES ▸ Adapted from the Center for Medical Simulation (Boston, MA) Code Status 6 Make a recommendation, do not just list the options.
“What's your understanding of how sick you are right now?”
Use silence. Respond to emotion before facts.
“If time were short, what would matter most to you?”
Describe what CPR actually is and, for a seriously-ill patient, what it realistically achieves.
Offer a time-limited trial when the path is genuinely uncertain.
SPIKES 6 S · Setting up — private space, sit down, the right people present.
P · Perception — ask before you tell.
I · Invitation — how much do they want right now?
K · Knowledge — give a warning statement first, then say it plainly: use the word "died".
E · Emotions — stop talking; validate the emotion; allow silence.
S · Strategy & summary — what happens next; the family is never left alone; chaplain/social work.
Family Update 6 Communicate early — a two-minute update is better for the family than a long wait.
Say plainly what happened and what the team did. Small chunks, then stop.
Say where things stand right now — alive, critical or stable, on a breathing machine — without promising a course you cannot see.
Respond to emotion before more facts — name it, and let silence work.
Say what happens next — where the patient is going, who takes over, and when they will hear more.
Bring them to the bedside as soon as it is safe, and name one person who will keep them updated.
SOURCES ▸ Ruled 2026-09-20 (split from the death-notification SPIKES card) CLEAR CHECKS & TIMERS — THIS PAGE Checks, weight and timers stay on this phone — no names, no record numbers, nothing leaves the device. Verbatim from the v1 harvest (@ ee60d25). Contested values were ruled 2026-08-25 — the ruling wins over anything shown here that lost. Each card's sources sit closed at its foot.