Code Flashcards
1
Q
When should a code blue be called?
A
- When a patient is unresponsive, apneic and/or pulseless
- Call for help (who should formally call for the code blue) and immediately initiate CPR
2
Q
What should happen once a code blue team arrives?
A
- Members of code team should identify themselves and their role (e.g. “I’ll take the airway” or “I’ll document”)
- A member at the nurses’ station should contact the patient’s healthcare provider as soon as the code is called
3
Q
What is the key to running an effective code blue?
A
- Quality and timeliness of interventions
- Early, high-quality CPR and rapid defibrillation (when indicated) before advanced cardiovascular life support
- Ensuring interventions such as vascular access and drug delivery sites are available in addition to having CPR done
4
Q
Describe the role of the compressor:
A
- The first HCP to respond assumes the role of compressor and immediately initiates chest compression’s
- Ensure backboard is placed when additional personnel arrive
- Switch out with another compressor every 2 minutes or 5 cycles to prevent decreased quality compression’s
- Restart compressions immediately after a patient has been defib’d
- Research supports delaying airway management and ventilation until additional help arrives, as passive delivery of air should be sufficient for first few minutes where chest compression’s are most important
5
Q
Describe the role of the airway manager:
A
- Provides ventilation’s using a bag-mask device attached to an oxygen source
- Set O2 levels to max rate (15 L/min) and ensure O2 is as close to 100% as possible
- Placement of an oropharyngeal airway may be placed to ensure airway patency while delivering ventilation’s with the bag-mask device
- Assist RT to perform intubation when necessary
- If available, a continuous waveform capnography can confirm and monitor endotracheal tube placements
6
Q
What are shockable rhythms examples?
A
- Pulseless ventricular tachycardia
- Ventricular fibrillation
7
Q
Describe the role of the defibrillator manager:
A
- Defibrillation of shockable rhythms, which is the only other therapy proven to increase survival
- Hands-free pads over handheld paddles are recommended as the safer and quicker option
- Ensures patient connected to a 3- or 5-lead cardiac monitor
- Have a good understanding of arrhythmias
- Understand the type of defibrillators available on the unit (monophasic vs. biphasic)
- When a shockable rhythm is identified, defib manager sets energy level (directed by team leader), announces when shock to be delivered (clear) and then repeat amount delivered after
- After 5 cycles of CPR, recheck rhythms again
8
Q
Describe the role of the crash cart manager:
A
Positions self on same side as patient’s venous access and has room to open drawers for easy access to contents (e.g. medications)
9
Q
Describe the role of the code team leader:
A
- Directs resuscitation efforts
- Communicates with all team members
- Monitors patient’s cardiac rhythm
- May be taken on by a physician or advanced care provider
- Takes over role until transferred to another physician (e.g. ICU physician)
- Respond to environment (e.g. ensuring there is enough space, arranging for extra patients in the room to be moved)
- Direct people who are present and not helping (e.g. wait outside until further help is needed)
- Communicate outcomes with MRP and family
10
Q
Describe the role of the recorder:
A
- Documents entire process
- Reminds team leader q2 minutes when it’s time for a compressor role switch and the time, name and dose of last medication administered
- Documents cardiac rhythms before delivering shock, and the ventilation efforts of patient
- Print rhythm strips
- Identify all patient indicators
- Note time of discontinued efforts, patient disposition and time of death if applicable
11
Q
Why is the postcode debriefing important?
A
- Discussion of what went well and what needs improvement
- Support for newer staff members
- Identify areas of needed staff education
12
Q
Describe basic code skills that will be used during a code blue:
A
- Initiate code blue
- Start CPR
- Position bag-mask device with attached oxygen
- Place the backboard
- Bring crash cart to room
- Arrange room for best patient and crash cart access
- Locate supplies and equipment on cart
- Attach ECG leads
- Attach defib pads
- Charge defibrillator and defib
- Administer medications
- Set up intubation equipment (e.g. endotracheal tube, laryngoscope, suction)
- Set up con’t waveform capnography
- Assume various roles
- Coordinate code
- Collaborate with other HCP’s
13
Q
Describe the role of the primary nurse as the first responder:
A
- Calls for help and activates code blue
- Initiates CPR and AED
- Remains with patient at all times; if no response after 1 minute, call code blue
- Remain available to provide chest compression’s and assist code blue team as required
14
Q
Describe the role of the second nurse as the second responder:
A
- Initiate code blue if not yet done (calls ARHCC Help desk using 7111 and states “Code Blue with location” two times”
- Ensures first responder equipment (AED) and patient chart brought to location
- Prepares location for code team (e.g. remove head of bed)
- Assists first responder with CPR
- Remains available to assist code blue team
15
Q
Describe the role of the PCC or charge nurse:
A
- Assumes responsibility for recording or designates to another until CCU nurse arrives
- Ensure appropriate number of staff available to assist, with runners designated PRN
- Ensures notification of MRP and family physician at start of code
- Assists primary nurse
- Ensure con’t function of unit
- Initiate follow-up as required
- Designs unit RN to restock first responder equipment and return to proper location
16
Q
Describe the role of the ICU nurse:
A
- Respond to code blue, bringing primary crash cart
- Assume role of monitor/electrical therapy nurse
- Identify self to team with role
- In absence of physician takes on leadership role, coordinating resp and cardiac efforts
- Works collaboratively with code blue team
