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response calls for physiologically acute changes in the patients were excluded. Immediate success of resuscitation services for Code Blue calls was 63.06%, beyond 24 hours this was 27.03% and at discharge this was just 9.01%. Factors such as age, time of Code Blue during or outside routine hospital working hours, associated comorbidities, procedures like dialysis, operation or chemotherapy done in the last 24 hours preceding the Code Blue and duration of CPR were found to have a significant effect on the success rate. Conclusion: We conclude, that formal training of all the healthcare providers on BLS is of paramount importance. Further in depth analysis is required to find out the root cause of the problems that are associated with the ‘Code Blue’ process which is affecting the success rates beyond routine hospital working hours. Keywords: Cardiac Arrest, Cardiopulmonary Resuscitation, Code Blue INTRODUCTION The use of color codes to designate emergencies to alert trained specific teams and respond quickly to those emergencies thereby preventing stress or panic around is an established process in hospitals across the globe.1 ‘Code Blue’ is one such common hospital emergency code. It generally indicates a medical emergency like a cardiac arrest requiring a trained team of advanced life support providers to rush to the specific location and begin immediate resuscitative efforts.2,3 Early initiation of cardiopulmonary resuscitation (CPR) and defibrillation are critical for improving survival. Every minute of delayed treatment decreases survival by 10%.4 The incidence of in-hospital cardio-respiratory arrest has been estimated to be 1–5 events per 1000 annual hospital admissions.5 It is estimated that approximately 2, 00,000 patients experience an in-hospital cardiac arrest every year in United States.6 There are established guidelines widely accepted and used internationally which provide logical, sequential algorithms for advanced cardiac life support (ACLS). Training and certification is also standardized almost universally. Yet outcomes are variable.7 Rate of successful CPR has been reported to be as low as 2-6% also in some studies even for in-hospital cardiac arrests.8 Other studies have reported widely variable successful CPR rates from 13%–59%.9 Survival to hospital discharge rate is a mere 0.42%.10 This indicates there are numerous factors which are inherent to the patient and also external factors which may influence the functioning of the ‘Code Blue’ process and the quality of CPR and thus determine the outcome.11 It is therefore essential to regularly audit and evaluate the ‘Code Blue’ services.12 Further studies in Indian settings on the functioning of ‘Code Blue’ systems is scare. The current study was undertaken to analyze the ‘Code Blue’ system and identify variables associated with survival at our multispecialty tertiary care hospital. The primary objective was to assess the success of ‘Code Blue’ in terms of survival. The other objective was to identify the patient and system variables associated with a favorable outcome and identify 1 Associate Professor, Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, 2 Associate Professor, Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, 3 Professor and HOD, Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, 4 Junior Resident, Department of Biochemistry, MGM Medical College and LSK Hospital, Kishanganj, India Corresponding author: Dr Maitraye Basu, Junior Resident, Department of Biochemistry, MGM Medical College and LSK Hospital, Kishanganj, India How to cite this article: Manasij Mitra, Dipak Sinha, Nupur Biswas, Maitraye Basu. A study on the success and other correlates of code blue cases in a multi-specialty teaching hospital in Bihar. International Journal of Contemporary Medical Research 2020;7(1):A1-A5. DOI: http://dx.doi.org/10.21276/ijcmr.2020.7.1.11 Mitra, et al. Success and Other Correlates of Code Blue Cases Section: Anesthesiology International Journal of Contemporary Medical Research Volume 7 | Issue 1 | January 2020 | ICV: 98.46 | ISSN (Online): 2393-915X; (Print): 2454-7379 A2 the practical problems associated with establishment and functioning of a Code Blue system. MATERIAL AND METHODS This was a cross sectional retrospective study done in a multispecialty teaching hospital in Bihar during the period from April 2018 to March 2019. Data was gathered from the Code Blue Report Form which had the demographic data, time of Code Blue call, area of Code Blue and the response time of the Code Blue Team. Further details of individual patients like initial rhythm at the time of Code Blue, any procedures preceding Code Blue, Outcome of the resuscitative measures with follow up were tracked from their medical records. Code Blue activated for cardiac arrest situations only were considered in the study. Emergency response calls for physiologically acute changes in the patient's mental status, respiratory rate, heart rate, oxygenation, blood pressure, hypoxia, and chest pain were excluded. Cardiac arrest was defined as the cessation of cardiac mechanical activity as confirmed by lapse in circulation, which was determined by the absence of a palpable central pulse, unresponsiveness as per the AHA 2015 guidelines. The Hospital has a laid down 

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