CODE BLUE

(Floor room)
 INDEX
 DEFINITION
 CODE BLUE CALL
 CODE BLUE TEAM
 BASIC COMPONENT
 DOCUMENTATION
 INITIATION OF CODE BLUE
 CPR
 RULES
 CODE BLUE (ACLS,BLS)
 DRUGS
 DEFINITION

 A hospital code used to indicate a patient

requiring immediate resuscitation.

 An emergency condition announced in hospital or

institution in which a patient is in
cardiopulmonary arrest, requiring a team of
provider sometimes called code team.

 To rush to specific location & begin immediate

resuscitation efforts.
Code blue call
HOW DO YOU CALL CODE BLUE ?

 To call code blue dial code blue number.

 Any phone in the hospital can be used to call

code blue team.

 It will alert locating and they will page the

code team.
 Code blue team

 The first responder is not actually a member of a

team but is the person who identifies and
confirms cardiopulmonary arrest.

1-Medical specialist/ ER specialist (Team leader).

2-ICU resident on duty (Airway).

3-Anesthesia resident (Specialist).

 Continue……..

4Resident on duty in charge of the patient

(compressor 1).

5 Medical resident on duty (compressor 2).

6 Nursing supervisor on duty (communicator).

 Continue…….

7 ICU nurse (Vascular access).

8 Ward shift incharge.

9`Bed side nurse (RN 1)---Recorder

10-Ward nurse (RN 2)-----Runner

11-Airway assistance
Code blue team
 Basic component

Crash cart-
 Cardiac monitor
 Defibrillator
 Emergency medicine
 Laryngoscope
 AMBU bag
 Miscellaneous medical supplies
 Cardiac board
Crash tolly
Laryngoscope
Cardiac board
 REMEMBER

 Always check the crash cart for these

emergency drugs.(Quantity, expiration date)
before starting you shift.

 By failing to prepare you are preparing to fail

in your role of saving lives
 Documentation

 Code team leader

 Written order
 Code note
 Charge nurse
 All patient data pertaining to the event.
 Medication administered
 Completing the chart
 Nurse note/charging.
 NOTE-

 If cardiac arrest in ICU will be

managed by ICU team an code is
not announced
 INITITATION OF CODE BLUE

1- The first responder is not CPR certified will call

for help and dial code blue number to initiate
code blue providing the following information
slowly & clearly and repeating the information if
necessary.

 Responder identify the location of the patient.

 Continue…

2- If first responder is BLS certified.

 She/he will start ABCs OR CPR, attached
defibrillator immediately upon arrived of this
equipment and continue CPR until code team
arrives a team leader takes over.
CPR
 The switch board will….

1Announce attention code blue in (area) three

times clearly and bleep the code blue team.
2The team leader will identify self as leader &
start conducting the procedure systemically
after analyzing the rhythm.
3Each member of the team will start
performing own role under guidance of the
team leader till told the stop.
 Continue…..

4Any change in role will be as per direction of

the team leader and all must stay an the scene
till allowed by him/her.
5The team leader will allow team member to
stand down or return to regular duty.
 REMEMBER-

RULE-1
• Calm down & do not panic.
• In case of emergency-

RUN LIKE HELL

RUN LIKE HELL
 RULE- 2

 Always start with the BCLS.

Chain of survival
The 5 links in adult chain of survival are-
1- Early access
2 Early CPR
3 Rapid defibrillation
4 Effective advanced life support.
5 Integrated post cardiac arrest care.
.
 Code blue

1- ACLS (Pulseless)
2-BLS(Pulseless)
 Sudden pulse loss & decrease perfusion in vital
organs.
 ACLS
Pulseless shockable rhythm.
There are 2 types of rhythm-
1-VT
2-VF
 Ventricular tachycardia

 A fast rhythm that originate in one of the

ventricle of the heart this is potentially life
threatening arrhythmia because it may lead to VF
& sudden death.
VT
 Ventricular fibrilation

 A turbulent, disorganized electrical activity of

the heart in such a way that the recorded ECG
deflection continuously change in shape
magnitude and direction.
VF
 .

 Continue CPR

 Record ECG

 Shock (If no rhythm)

 Drugs-
 Drugs

 Epinephrine (IV)-
 Dose- 1 mg 3-5 min. repeat
 3rd round IV amioderone 300 mg repeat after
few minuet dose will be 150 mg.
 IV mg – 1-2 mg also can be given pulseless VT
shockable rhythm.
 BLS

 Pulseless non shockable rhythm.

 Asystole -No rhythm no pulseless
electrical activity.
 CPR-
 Epinephrine 1 mg 3-5 min IV
 Atropine upto 3 mg---- check pulse,if pulse is
there shift the patient in ICU 24-48 hrs.
What is the cause of shockable rhythm?

 6T
 Tension pneumothorax(air within the pleural space).
 Cardiac tamponed (fluid collection in the pericardial cavity)
 Thrombosis (blood clot within the blood vessels)
 pulmonary MI (pulmonary congestion)
 Trauma
 Toxins
 Continue…..

 6H
 Hypovolemia (loss of body fluid )
 Hypoxia (depletion of oxygen in tissue)
 Acidosis (Decrease of blood PH-7.35-7.45)
 Hyperkalemia(Increased Potassium 3.5-5.5meq/L)
 Hypokalemia
 Hypothermia (Decrease in body temp. 35-38 C)
Thank You