CODE BLUE
Code Blue
CODE Blue To administer advanced adult/pediatric life support to all unresponsive patients.
Step 1: Code Blue Team & members
1. Code Blue ( Adult): 1. Code Blue ( Paed):
Clinicians from: Clinicians from:
i. Intensive Care Unit i. Intensive Care Unit
ii. Accident & Emergency ii. Representative from Pediatrics
iii. ICU & Emergency Nursing iii. Accident & Emergency
Staff iv. ICU & Emergency Nursing Staff
Step 2: Code Blue Announcement
“Announcement”:
1. Code Blue – Adult – ICU/Emergency/Ward.
2. Code Blue – Pediatric – PICU/NICU/Emergency/ward.
Step 3: Code Blue Team Responsibility:
i. Responding immediately to all Code Blues.
ii. Conducting the code according to current Advanced Cardiac Life Support (ACLS) or Pediatric Advanced
Life Support (PALS) protocols.
iii. Recording any pertinent data on the patient’s record.
iv. The Code Team Leader shall ensure that the document of the event are made in the patient’s medical record.
v. The Nursing unit, /or department on which the Code occurs, shall be responsible for initiating Basic Life
Support (BLS) until the Code Team can respond.
vi. The staff responsible / Nursing supervisor in that particular patient care area on which the Code occurs shall
be responsible for, Overseeing traffic control on the unit with the help of the security.
Ensuring that emergency equipment is brought to the bedside.
Delegating duties to appropriate personnel to ensure the unit’s continued function.
Serving as the recorder for the resuscitation efforts or delegating an appropriate person to do so.
Documenting and completing the Cardiopulmonary Resuscitation form.
Arranging a bed if the patient needs to be transferred to a critical care bed.
Evaluating the situation to see if additional personnel are needed to ensure that the Patient Care Area
continues to function.
vi. The patient’s primary physician shall be responsible for:
Making arrangements for an ICU bed if needed.
Informing the patient’s family of the situation.
Completing the medical record if the patient expires, documenting the events leading up to the
patient’s death, cause of death, date and time of death, autopsy requested, and physician signature.
The nurse member of the Code Team is responsible for managing the crash cart during the code
and administering the drugs when the doctor is unable to do so, reviewing the code sheet
documentation post code and following up to ensure complete documentation.
Resuscitation efforts are documented in patient’s chart.
The outcomes of resuscitation are regularly audited using the post event analysis form.
The audit results are analyzed by the chairman of the committee
The results of audit are discussed in a multidisciplinary committee and root cause analysis
is done whenever necessary.
Necessary corrective and preventive actions are planned based on the analysis and
documentation is carried out. The team will also look into the implementation of the
previous corrective and preventive actions and informed to all concerned
Code Blue- Crash Cart Trolley
i. One nurse is assigned, in writing, each day to check the crash trolley in his/her area.
ii. The nurse must review the crash trolley contents against the checklist and record any
discrepancies
iii. Verify the date of expiry of the medication on last Saturday of every month
A department staff member will check the defibrillator to ensure
i. Defibrillator is plugged into an electrical outlet
ii. Cleanliness of the paddles
iii. System check for defibrillator
iv. Presence of ECG cable
v. A supply of: defibrillator pads or gel electrodes
vi. Recorder paper(if provision made)
vii. Presence of (1) external pacer cable and (2) pacer pads (only where indicated)
viii. If a defibrillator ECG cable is missing or fails -to charge/ discharge, report to Biomedical
Engineering immediately for replacement. Indicate that it is out of service by labeling
"Broken Equipment”.
ix. Staff will document the defibrillator check by signing and dating the defibrillator check sheet every shift.
On the notebook attached to the defibrillator. Crash cart needs to be checked in the following manner:
The oxygen cylinder must be checked daily for a sufficient amount of oxygen; clean tubing attached to an
unused ambu bag with a clean mask in a plastic bag.
Laryngoscope are clean, the bulb fixed securely, functions and the appropriate blade handles fixed
The nurse is responsible for ensuring that the crash trolley exterior and interior are clean and will clean any
part, which is required.
No staff is to add more drugs or equipment, delete items, or rearrange anything in any way. Every sterile
item must also be checked for sterility. The nurse is responsible for the condition and contents of the trolley
once he or she has checked it
The crash cart must be placed in an area in the ward away from public thoroughfares but must be in a place,
easily accessible in the event of a cardiac arrest.
