Thirty years ago, I ran a cardiac arrest in the operating room. The patient survived. The room eventually quieted down. The nurses began cleaning up. People moved on to the next case.
But I remember standing there afterward feeling exhausted and unsettled. It had been several months since my ACLS recertification, and during the code I caught myself mentally reaching for details of the algorithm that had once felt automatic. I knew the principles. I knew how to run a code. But I also realized something uncomfortable: With every passing month, parts of that memorized structure faded a little more.
And if I felt that way as an experienced anesthesiologist, how many other clinicians felt the same thing but never said it out loud?
That experience stayed with me. Afterward, I actually called the manufacturer of our physiologic monitors with a simple idea: Why not place the ACLS algorithms directly into the monitor itself? Static. Always visible. Available when clinicians needed them most.
They declined. But I never forgot the idea.
Over the next three decades, medicine transformed itself technologically. We digitized imaging, monitoring, charting, and communication. Yet one of medicine’s most time-sensitive emergencies still depended heavily on memory under stress.
During a cardiac arrest, clinicians must simultaneously interpret rhythms, manage airways, track medication timing, communicate with the team, document events, and anticipate the next intervention, all while operating in an emotionally charged environment where seconds matter. Even experienced clinicians can become cognitively overloaded during prolonged or chaotic resuscitations.
This is not a training problem. It is a human problem.
Eventually, my co-founder, an emergency medicine physician, and I decided to build the tool I had imagined decades earlier. We created The Code Runner Pro, a digital platform designed to provide real-time ACLS and PALS workflow support during resuscitations while automatically generating a timestamped event summary.
But the deeper issue is larger than any individual app. The question medicine should probably begin asking is this: Should clinicians managing one of the highest-stakes situations in health care still be expected to rely primarily on memory alone?
No technology will ever replace judgment, teamwork, or experience during cardiac arrest care. But cognitive overload itself may be one problem we can finally begin to address.
Michael Peck is a retired anesthesiologist with more than 40 years of clinical experience in academic and private practice medicine. Formerly an assistant professor at the George Washington University, he previously served as co-director of neuroanesthesiology and has lectured nationally and internationally on anesthesia and perioperative care.
Dr. Peck has long been involved in airway management, patient safety, and medical innovation, including the development of novel airway devices and digital tools designed to support clinicians during critical events. He is co-developer of Code Runner Pro, a mobile application focused on improving adherence to ACLS and PALS protocols during resuscitations. His interests include medical education, simulation, clinical decision-making under stress, and the intersection of technology and patient care.
His publications and contributions span neuroanesthesia, airway management, anesthesia board review, and perioperative care. His work includes chapters and contributions in Cranial Microsurgery: Approaches and Techniques, Essence of Anesthesia Practice, Anesthesia Board Review, Anesthesiology Keyword Review, and Defined Keywords: Review for Anesthesia Boards. He has also published on bradycardia with use of a subarachnoid drain, endotracheal tube obstruction, postoperative nausea and vomiting, propofol during emergence from anesthesia, esmolol and cerebral blood flow during isoflurane anesthesia, and systemic lupus erythematosus in pre-anesthetic assessment. He shares updates on LinkedIn.
