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Responders
Director of the Code: All house staff that is near the site of the Code Blue shall respond. Physician staff may be dismissed from the Code Blue scene after the “physician in charge” is determined. The physician in charge must be clearly identified as being in charge. Responsibilities include:
Direct all activities of the resuscitation effort
Delegate or directly participate in airway management, vascular access, medication orders, and maintaining Advanced Cardiac Life Support (ACLS) interventions
Recording Nurse: The nurse assigned to the patient should be the person that documents all the events of the code for reasons of continuity in documentation and ability to provide information regarding the patients hospitalization, current treatments, medications and the events that occurred immediately before the code. The recording nurse is responsible for:
Ensuring the patient chart is brought to the room when the code is called Utilizing the Resuscitation Record to document events of the resuscitation effort, and assists with utilization of the Crash Cart including medication and IV preparation
Place the completed Resuscitation Record in the chart. Progress notes should indicate patient condition prior to resuscitation “code call”. If necessary a “late entry” describing patient condition prior to the resuscitation event should be recorded. A notation must be made in the progress notes referring to the Resuscitation Record for events of the resuscitation. Ensuring the family and physician has been contacted Transport patient to Critical Care Unit
Medication Nurse: This “hands on” nurse is responsible for:
Initiating BLS-HCP measures according to American Heart Association (AHA) standards
Provide ACLS measures
Initiate cardiac monitoring
Locate/apply quick-comb redi-pak that can be utilized for defibrillation, cardioversion, transcutaneous pacing, and viewing the cardiac rhythm.
Assess for patent IV and/or assist with the initiation of IV route Prepare, label and administer medications per physician order Assemble equipment for intubation and suctioning
Respiratory Therapist: Three respiratory care staff is assigned each shift to respond to
Code Blue. Respiratory Therapists responsibilities include:
Perform BLS-HCP according to AHA standards
Maintain airway by suctioning and manual ventilation before intubation Assist physician with intubation and securing endotracheal tube (ETT) Obtaining blood sample for arterial blood gas analysis
Set up oxygen and ventilation equipment Assist with transport to critical care unit
Ensure proper paperwork is completed for the Respiratory Care Department
Anesthesiologist: If the physician is unable to intubate the patient, the operator may page an anesthesiologist (call 3375 to confirm an anesthesiologist was contacted) to intubate the patient, ensure an adequate airway and to facilitate ventilation.
Unit Secretary: The unit secretary must remain at the nurse’s station to contact the appropriate personnel upon request, place orders in the computer, and answer the telephone.
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.