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Charge Nurse/Nursing Supervisor: The supervising nurse acts as a resource facilitator for the code team. The resource facilitator is responsible for: Communicating with personnel regarding equipment and ancillary service needs. Coordination of the initial resuscitation effort, assisting the recording and medication nurse Checking on and removing any other patients or visitors in the room as necessary Making space for the resuscitation effort Clearing unnecessary staff from the room Those who are not listed as team members and who are not actively participating in the resuscitation effort. Coordinating the transfer effort by contacting Registrar and/or ICU/CCU to facilitate transfer of the patient after resuscitation. Directing actions of the “runner”. Monitoring of the continued care of other patients Notifying the attending physician, and patient’s family. Assisting with evaluation of the resuscitation effort. Nurse Assistant: One nurse assistant could be delegated to remain outside of the room to assume the role of “runner”. The responsibilities may include: Running errands Obtaining supplies/equipment Transferring patients to another area. The remaining nurse assistants will remain on their assigned unit. When the NA is utilized as a runner, provide specific instructions regarding what is wanted, where it is located and how quickly you want it. ACLS Medication Summary Medications administered during a code depend on the cause of arrest, cardiac rhythm and patient’s response. The goal of treatment with medications is to reestablish and maintain cardiac function, correct hypoxemia, and suppress cardiac ectopics Most Frequently Used Code Drugs Drug Indication Adult Dosage Amiodarone Ventricular Fibrillation (VF) Pulseless Ventricular Tachycardia (VT) Ventricular Tachycardia (VT) Amiodarone IVPB is obtained in Pharmacy Cardiac Arrest: 300mg IV in 3-5 minutes (dilute to 20-30ml D5W). Consider repeating 150mg IV in 3-5 minutes. Max cumulative dose: 2.2g IV/24 hours. Wide Complex Tachycardia (stable): 150mg (diluted)rapid IV over first 10 minutes (15mg/min) May repeat rapid 150mg dose every 10 minutes as needed Slow infusion: 360 mg IV over 6 hours (1mg/min) Maintenance infusion: 540mg IV over 18 hours (0.5mg/min) Atropine Bradycardia Asystole Pulseless electrical activity (PEA) Asystole or PEA: 1mg IV. Repeat every 3-5 minutes. Max total dose: 3 doses (3mg) Bradycardia: 0.5 mg IV every 3-5 minutes as needed., max 0.04mg/kg ETT: 2-3mg diluted in 10ml normal saline Epinephrine Ventricular Fibrillation (VF) Pulseless VT Asystole Pulseless Electrical Activity (PEA) 1mg (10ml of 1:10,000 solution) IV every 3-5 minutes. Follow each dose with 20ml N.S. IV ETT: 2-3mg diluted in 10cc N.S