Code Blue Protocol. pptx. Cardiac arrest management in hospital

Nurses training program for Arrest management

1. WORK SHOP ON CODE BLUE MANAGEMENT

2. Introduction Godwin Sujin.G B.Sc (N).,MBA(HM) Quality Team Dr.Jayaharan Memorial Hospital Nagercoil

3. A message announced over a hospital’s public address system, indicating that a cardiac arrest or respiratory arrest requiring CPR is in progress; to be “coded” is to undergo CPR . Dr.Jayaharan Memorial Hospital code to be used by all staff to summon a trained team of medical personnel to undertake cardio - pulmonary resuscitation.

4. MET CODE BLUE The patient is still responsive but there is a sudden deterioration in patient’s status Respiratory distress O2 saturation, Blood pressure, pulse is gradually dropping/below normal The patient is unresponsive No respiration No pulse What is the difference between Medical Emergency Team ( M ET ) from Code Blue ?

5. It is the sudden loss of cardiac function, when the heart abruptly stops beating. Unless resuscitative efforts are begun immediately, cardiac arrest leads to death within a few minutes.

6. Team of providers sometimes called a “ code team” being required to rush to the specific location and begin immediate resuscitative efforts in an emergency situation announced in a hospital or institution in which a patient is in cardio - pulmonary arrest .

7. The First Responder is not actually a member of a team but is the person who identifies and confirms cardiopulmonary arrest.

8. 1. Medical Specialist On Call/ ER Specialist for ER Code Assume overall responsibility or the direction of activities. Communicate with event manager/recorder Issues all medical and resuscitative orders including resuscitation medications. Termination of Code Blue and final disposition of the patient. Communicate with patient’s family along with Nursing Supervisor at the end of the code. Complete documentation for medical records.

9. 2. ICU Resident on Duty Manage the airway as directed by the team leader Perform bag-mask ventilation Prepare and assist with intubation Confirm ETT placement Secure ETT Complete documentation in the medical record

10. 3. Anesthesia Resident Manage the airway if ICU resident is delayed Respond to instructions from Team Leader for changing roles Complete documentation in medical records

11. Ward Staff on Duty in charge of the patient Perform an continue chest compression as instructed by team leader. Hand over to Compressor 2 when tired. Complete documentation in medical records

12. 5 . Nursing Staff on Duty Relieves Compressor 1 when tired Complete documentation in the medical record.

13. Nursing Super intendent on Duty Help rapid transport of blood samples to laboratory Manage crowd control with security Communicate with the family Notify patient Affairs, Social Worker, Interpreter Attend to pastoral needs of the patient Coordinate patient transfer and placement with team leader.

14. 7. ICU Nurse Established vascular access and ensure patency Administer IV medication as per verbal order of team leader Assist airway and intubation Insert NGT as indicated

15. Nurs ing Supervisior Ensure providers assume pre- assigned roles and that the team knows who is responsible for what role Assign RN1 as recorder Assign RN2 to bring equipment needed Once roles established, ensure management of the rest remaining work in the ward/unit. Ensure crowd control with the help of security with in the room/ward. Notify the switch board if code is over.

16. 9. Bedside Nurse (RN 1) Provide history using SBAR communication Stay at bedside Ensure availability of workplace Continue as the recorder Maintain accurate written record of the timings of all intervention.

17. SBAR What is SBAR Communication

18. Ward Nurse (RN 2) Get and ready the crash cart, other equipment such as suction. Clearly state “I am getting…” Distribute code cart supplies Operate monitor/defibrillator Prepare medication according to order from team leader Receive instruction from ICU RN or team leader.

19. 11 . Airway Management Helps ICU, anesthesia residents in airway management

20. CODE BLUE R N 2 R N 1 ICU NURSE COMP.2 COMP.1 EVENT MANAGER OTHERS OTHERS

21. Arrest Management

22. Chain Of Survival- Adult

23. Adult Basic Life Support

24. Adult Cardiac Arrest Algorithm

25. Adult Cardiac Arrest Circular Algorithm

26. Post- Cardiac Arrest Care Algorithm

27. Adult Brady cardia Algorithm

28. A dult Tachycardia With A Pulse Algorithm

29. Pediatric Basic Life Support- Single Rescuer

30. Pediatric Basic Life Support- 2 or More Rescuer

31. P ediatric Cardiac Arrest Algorithm

32. Neonatal Cardiac Arrest Algorithm

33. CRASH CART

34. Always check the crash cart for these emergency drugs (quantity, expiration date) before starting your shift. “By failing to prepare you are preparing to fail in your role of saving lives”

35. CODE BLUE FLOW SHEET

36. CODE BLUE PROGRESS NOTES

37. CODE BLUE QUALITY REVIEW CHECK LIST

38. Initiation of Code Blue The first responder, if not CPR certified will: Call for HELP and dial “ 9 ” ( Reception ) to initiate CODE BLUE providing the following information slowly and clearly and repeating the information if necessary: o Responder identity o The location of the patient

39. 1. If first responder is BLS certified: She/He will start CAB s of CPR, attach defibrillator immediately upon arrival of this equipment and continue CPR until code team arrives an team leader takes over.

40. Announce “ATTENTION …CODE BLUE IN ( area )” three times clearly and bleep the Code Blue team. Continue to be attentive and direct responders to the location.

41. The team leader will identify self as leader and start conducting the procedures systematically after analyzing the rhythm. Each member of the team will start performing his/her role under guidance of the team leader till told to stop. Any change in role will be as per direction of the team leader and all must stay on the scene till allowed by him.

42. Termination of Code Blue It is decide by the team leader. If MRP of the patient available on site, his/her opinion can be sought in making this decision. 1. The team leader will allow team members to stand down an return to regular duties, with exception of the Medical Specialist an Nursing supervisor who will asses an coordinate further intervention, as required.

43. RULE #1 CALM DOWN and DON’T PANIC

44. CPR is as easy as C-A-B

45. Oral Intubation

46. We are hoping to see competent nurses during code blue.