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resuscitation out of hospital are discharged home without major neurological disability. Patients at high risk of subsequent cardiac death.10 Sheetal Singh et al 116 Flow Chart 1: Process flow during “Code Blue” Code Blue Policy for a Tertiary Care Trauma Hospital in India International Journal of Research Foundation of Hospital & Healthcare Administration, July-December 2015;3(2):114-123 117 JRFHHA Who can Activate code blue? Any individual may call a Code Blue and certified staff will initiate basic life support (BLS) and automated external defibrillator(AED) if available, untilrelieved by the Code Blue team. How to Activate code blue?11 • The Code Blue team has to be notified by the control room (room designated to notify the message to the response team) • The individual calling the Code Blue must dial the designated number to call a Code Blue • Identify yourself to the call centre staff who responds to the call • Give the exact location (i.e. unit, floor, wing, building) • Tell him/herthat there is a adult/pediatric Code Blue • Code Blue team will be notified using public address system. What Happens when code blue is Announced?12 • When Code Blue is announced the message is sent to the Code Blue team (Annexure 1), who are expected to arrive at the scene as soon as they get the message (Code Blue response time is expected to be < 3 minutes). • The members of the Code Blue team must ensure that the area/scene is safe before proceeding with their response. This requires rapid assessment of the location and circumstances associated with the Code Blue call. • The members of the Code Blue team will not respond to areas where unpredictable and variable environmental conditions exist. When a Code Blue is called, all members of the Code team will respond immediately. • Refertoappendicesforsite-specificinformationregarding members of the Code Blue team (Annexure 1). • Code team members function collaboratively during the code with one person identified as the code team leader. • TheCodeBluewillfollowthe advancedcardiovascular life support (ACLS) guidelines. It is recommended all members have current ACLS training and certification. Annexure 1: Responsibilities of Code Blue team team Leader Doctor from department of anesthesiology will be the team leader • Designates roles to team members and directs their actions • Decides appropriate treatment as per ACLS guidelines and gives orders to team members • Decides appropriate disposition of patient once stabilized • Brief the patient’s attendant after resuscitation and will make sure that information has been passed to patient’s family members • Ensures that one member (nursing) is designated to record events in the Code Blue flow sheet (Annexure-3) and get it verified from the team leader • Fill Code Blue report (Annexure 2) and submit to the Code Blue committee. Physician or Anesthesiologist Manages the airway and circulation. One Nurse • Assists doctor in managing the airway • Assists in obtaining intravenous access and drug administration as per team leader’s instructions • Assists in managing code as requested • Will remain with the patient until the transfer occurs? Other Nurse • Automated external defibrillator (AED)/defibrillator switched on • Monitor rhythms through AED pads /ECG leads/paddles • Rhythm analysis and shock delivery as advised by Code Blue team leader • Fill Code Blue flowsheet and attach to the patient’s medical record after showing the same to team leader. security Personnel • Directs team members toward code location • He must ensure the area/scene is safe before proceeding with their response • Ensures that no crowding of Code Blue site takes place. Hospital Attendant • Help nursing staff in pushing crash card near the patient • Assists in various other activities. Code Blue Policy for a Tertiary Care Trauma Hospital in India International Journal of Research Foundation of Hospital & Healthcare Administration, July-December 2015;3(2):114-122 117 JRFHHA Need of the Study Cardiac arrest is a medical emergency that, in certain situations, is potentially reversible if treated early. Unexpected cardiac arrest can lead to death within minutes: this is called SCD.5 Despite advances in the prevention and treatment of heart disease and improvements in emergency trans­port, the proportion of cardiac deaths classified as “sudden” remains high, probably because of the unexpected nature of SCD and the failure to recognize early warning symptoms and signs of heart disease. The age-adjusted SCD rates and the state-specific variation in the proportion of SCDs suggest a need for increased public awareness of heart attack symptoms and signs.7 Death and disability from a heart attack can be reduced if persons having a heart attack can immediately recognize its symptoms and call for emergency care. Prehospital emergency medical service systems can assist in reducing SCD rates by dispatching appropriately trained and properly equipped response personnel as rapidly as possible in the event of cardiac emergencies. However, national efforts are needed to increase the proportion of the public that can recognize and respond to symptoms and can intervene when someone is having a heart attack, including calling a designated number, attempting cardiac resuscitation, and using automated external defibrillators until 

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