RESPONDING TO A

CODE
 A. Introduction
In an Emergency situation in the
hospital setting, time is of the
essence. This topic will
somehow help the students
achieve a better understanding
on how to systematically respond
to person on cardiac arrest and
help begin to learn and
understand roles and
interventions used by the
resuscitative teams.
 The Chain of Survival Concept
is a linked chain which applies to
cardiac arrests in-hospital as well
as arrest in the pre-hospital arena.
The four links are as follows;
 Early Access – a cardiac emergency
must be recognized and respond to

 Early CPR – some efforts at opening

the airway, ventilation and blood
circulation must occur as soon as
possible

 Early Defibrillation – identification

and treatment of VF is the single most
important intervention

 Early ACLS – advanced airway control

and rhythm-appropriate IV
medications must be administered
rapidly.
 B. Working Objectives
1. Know and locate the common
anatomical and topographic terms of
body positions, location, direction and
its body cavities;
2. Know and describe the major functions
of the heart and lungs;
3. Know and demonstrate basics in adult
BLS;
4. Recognize simple arrhythmias; and
5. Know and describe practical ways in
assisting to a CODE.
 C. Key Terms
1. Anatomical Position – Unless
otherwise indicated, all references
made to body will utilize the
“anatomical position” – standing
erect with arms down at the sides,
the palms facing you.
2. Supine Position – the patient is lying
face up (on the back)
3. Prone Position – the patient is lying
face down on the stomach.
4. Lateral Recumbent – the patient is
lying on the left or rightside.
 Terms of Direction and
Location
• Superior – toward the head
(cranial)
• Inferior – toward the feet
(caudal)
• Anterior – toward the front
(ventral-the belly side)
• Posterior – toward the back
(dorsal-the backbone side)
• Medial – toward the midline or
center of the body
• Lateral- to the right or left of
the midline or center of the
body
• Proximal - near the point of
reference
• Distal – far away from the point
of reference
• Superficial – near the surface
• Deep – remote from the surface
• Internal – inside
• External – outside
 Body Cavities
the organs of the body are
located in certain cavities,
the major ones of which
are cranial, spinal,
thoracic, abdominal,
abdominopelvic (4
quadrants) and pelvic
cavities.
Basic Life Support (BLS)
the action taken during the
first few minutes. This
sequence save lives. It is a
resuscitative continuum,
which attempts to give an
airway, adequate ventilation,
and mechanical circulation to
the vital organs.
Advance Cardiac Life Support
(ACLS)
it is the latter continuum,
with recognition of a cardio
pulmonary / cardiovascular
emergency and moves
through defibrillation,
advanced airway
management, and rhythm
appropriate I, V medications.
 D. Discussion
Part I
A. Anatomical Regions, and its Body
Cavities
B. Major Functions of Heart
1. Circulatory System – has 2
major fluid transportation systems
a. Cardiovascular – transports
blood in all parts of the body
b. Lymphatic – provides
drainage for tissue fluid
2. Conduction System
 CARDIAC ARREST
Warning Signs:
1. Chest pain that may radiate to
shoulders and jaw
2. Nausea and vomiting
3. Cool, pale, moist skin
4. Weakness, and a “ feeling of
being sick:
5. Fluctuating pulse
6. Perspiring (diaphroresis)
7. Difficulty in breathing (dyspnea)
 C. Major Functions of the Lungs

- Provides transports of the oxygen

- Oxygen is made available to the blood
through the respiratory system and
to the body cells by circulatory
system.
 RESPIRATORY ARREST
Warning Signs of Respiratory Distress
1. Diminishing speech, whispering or
grunting.
2. Restlessness and anxious
3. Nasal flaring
4. Tracheal tugging – the Adam’s apple
is pulled out upward or inhalation
5. Retraction of intercostals spaces
6. Use the diaphragm and neck muscles
during exhalation.
7. Bluish discoloration of the skin an d
mucous membrane (cyanosis) – late
sign
-Oxygen is cut off to the lungs, heart and
brain. The may continue to pump,
oxygen stored in the lungs and blood
will continue to circulate to the brain
and other vital organs in the body. But
when the heart muscle (myocardium)
experiences hypoxia the heart falters
and stops, resulting to cardiac arrest

Clinical Death – 0 Minute cessation of

breathing and circulation

Brain Damage Begins – 4-6 minutes

Biological Death – 10 minutes brain cells

begin to die..
 Part II
A. Basics in Adult BLS
Patient Assessment
1. Determine unresponsiveness.
2. call fast / activate the code
system, if necessary.
3. achieve control of the cervical
spine, if necessary.
4. Open the airway with the
appropriate maneuver of head
tilt/chin-lift or jaw thrust (may use
cross finger technique, if necessary)
- Position the patient
- Open the airway
- Check for breathing (LLF-max 10
sec.), provide rescue breathing
using the most efficient method,
mouth to mouth, mouth to mask
ventilation, or mouth-to –bag
valve mask ventilation.
- With no supplemental oxygen:
tidal volume and inspiratory
times is the same with mouth to
mouth.
- With suplemental oxygen
(Minimum flow
- With supplemental oxygen
(Minimum flow rate is 8 –
121/min): lower tidal volume is
recommended for arterial oxygen
saturation.
- May use alternative devices
- Pulse check
- Chest Compressions
NOTE: Changing Positions, the
one doing the compressions will
call for a
B. Arrhythmias Recognition
- Interpret ECG and rhythm
information within the
context of total patient
assessment
 Part III: Team Approach to
ACLS in Response to Code
- Airway Adjuncts
- Basic pharmacology in
ACLS
- Practical Ways in assisting
to CODE