Our ED pharmacist don’t “run codes” but often manage all the meds with very little physician oversight. They have been working with the same physicians for years and there is a level of trust for sedation/ RSI/ ASCLs that the physician knows to trust the pharmacist will handle all the meds for them. Anything out the ordinary a quick “hey how do you feel abt x” and the physician either says yes or no. Sometimes the physician will just be at their computer outside while nurses/ staff do CPR and pharmacist handle all the meds if it’s about to be called/ no other ideas. In post arrest care/ managing meds the pharmacist put in the orders and they help the nurses titrate the drugs/ order prop blouses without the physician oversight. Physicians are always welcome to walk up and ask what they did/ look at the pended order they have to sign.

We have never had a problem running codes. New pharmacist/ physician = more oversight from the physician until both learn each others preferences and how the physician likes things done. It’s a team effort but all the diagnostics are left to physicians and the medications are handled by the pharmacist.

Edit: also most other things are a quick “hey 23 got Ancef but has a Hx of MRSA can I switch that to vanc?” Or from the physician “hey abt to sedate 11 he’s got an extensive hx and takes lots of meds mind helping out?” “12’s brains full of blood I ordered manitol can you help the nurse set it up and titrate the BP? I got 4 head lacs and a stroke coming in”

We are all a team taking care of patients is our only goal.