Nursing Orientation Code Blue 1

Roles and Responsibilities During A Code Blue

Code Team The following people comprise the Code Team and respond when a Code Blue is called: Bedside Nurse The nurse who knows the patient best should be relieved of any BLS/ALS duties so they can get the patient's chart and prepare to communicate key information to the code team. Physician/Resident The physician/medical resident oversees the code, gives the orders, may perform chest compressions, defibrillates the patient, and terminates the code. The physician/medical resident also determines disposition of patient post-code, writes transfer orders, documents in the medical record, performs pronouncement of death, and notifies appropriate individuals. Anesthesia The anesthesia representative intubates the patient and maintains the patient's airway. Respiratory Therapist The respiratory representative may also intubate the patient, maintains the airway, ventilates the patient and performs ABG’s. Critical Care Nurse The ACLS certified critical care nurse defibrillates the patient, Administers medications and prepares for external pacing. Recorder Nurse The recorder nurse communicates with whoever is in charge of the code, and records interventions on the code blue data sheet, it is important that the recorder Nurse and the Physician sign the Code Blue form. Crash Cart Nurse The crash cart nurse prepares and may administer medications, and distributes supplies from the crash cart. Additional Nursing Personnel Additional nursing personnel control the flow of people in the area. They may also notify the family or attending physician, delegate essential care to others who can answer call lights, give medication and provide family support. INITIATING A CODE BLUE -Policy #466 CALLING A CODE BLUE IN THE HOSPITAL The first person to determine the need for CPR will summon help, initiate CPR, call Code Blue-

City – 1-2222 MNLD – 2-2222

CODE PROCESS:

ABC’s started – Airway, Breathing, and Circulation (We follow A.H.A. BLS & ACLS/PALS/NALS Guidelines).

Nursing Orientation Code Blue 2

Obtain Code Cart, place bed flat, use quick look paddles to ascertain rhythm, and apply monitor leads or external defibrillator/pacemaker pads asap, place backboard under patient

Obtain IV access sites – hang NS as the generic fluid Think about patient’s roommate, visitors

CODE CART QUICK FACTS

A laminated list of Code Cart Supplies should be attached to your Code Cart. If you are not familiar with the supplies, please review.

How often is the cart checked? (For full details – Refer to Emergency Medication and Equipment Check Policy #1051.)

Each time a new crash cart is delivered to unit from SPD Every shift Each month the respiratory and SPD draws must be checked and re-locked

to ensure that contents are available and not outdated, this is the responsibility of the unit. Policy stipulates that this will be done on the first day of every month.

A monthly check of medications will be performed by pharmacy. Unlike the re-usable laryngoscope blades, the disposable blades do not have a bulb.

The bulb must be replaced within the handle itself. There is a bulb replacement tool (a little tubular piece) that comes with a new handle or with every 5th replacement bulb.

DO NOT discard, it is needed to unscrew the bulb. Please make sure you have this tool if not, contact SPD.

Defibrillators must be checked on each shift – please review instructions attached to the defibrillator on your unit, if you have any questions – please ask your preceptor.

1. Who must sign the Code Blue Documentation Form?

a. The recording nurse b. The physician c. All the above

2. To call a code blue at the MNLD Campus you would dial?

a. 12222 b. 22222 c. 2-BLUE d. 1-2345

3. Who is responsible to restock meds after a code

a. The recording RN b. The Administrative Associate c. Pharmacy d. None of the above

Nursing Orientation Code Blue 3

4. The code cart is checked

a. Every shift b. Each time a new crash cart is delivered to unit from SPD c. On the first of the month each unit checks the SPD & Respiratory Drawer d. All the above