INTRO TO CODE BLUE

PURPOSE

Experience management of code blues Suggest plans for acute care cases

Practice leadership and teamwork skills Practice early CPR and defibrillation
Pengertian

“Suatu tanda atau sinyal yang digunakan oleh rumah sakit untuk
memberitahu bahwa seseorang membutuhakan tindakan resusitasi,
yaitu pasien yang mengalami henti nafas dan henti jantung”

Ruang lingkup : seluruh lingkungan RS , IGD, rawat

inap, kamar operasi, ruangan intensif, rawat jalan,
tempat pemeriksaan penunjang, dll
TIM

Code blue response team atau tim code blue adalah

suatu tim yang dibentuk oleh rumah sakit yang bertugas
merespon kondisi code blue didalam area rumah sakit.

Tim ini terdiri dari DOKTER dan PERAWAT yang

sudah terlatih dalam penanganan
kondisi cardiac respiratory arrest.
TIM

LEADER (DOKTER JAGA/PPDS)

Perawat AIRWAY

Perawat BREATHING

Perawat COMPRETION

Perawat DEFIBRILASI
INTRO TO CODE BLUE
KASUS-KASUS CODE BLUE

Tension Pneumothorax
| Pulseless VT

ACS | VF

Anaphylaxis | Asystole

Upper GI Bleed | PEA

INTRO TO CODE BLUE
KASUS-KASUS Code Blue
Hypovolemia Tension PTX

Hypoxia Tamponade

Hydrogen ion Toxins

Hyper/hypokalemia Thrombosis (pulmonary)

Hypothermia Thrombosis (coronary)

INTRO TO CODE BLUE
PENILAIAN
PRIMARY SURVEY
Assessment Action
AB C Help, O2, IV, Monitor

SECONDARY SURVEY
Assessment Action
Riwayat, TTV, Pemfis Tindakan / treatment

CODE BLUE
Assessment Action
Irama, Nadi CPR/Defib, EPI
INTRO TO CODE BLUE
PRIMARY SURVEY
Primary Survey Assessment Action
Examples Examples
Segera, mengancam Airway: kepatenan, Call for help
jiwa sekresi, obstruksi
O2
Breathing: RR, Sat. O2,
suara napas, deviasi Needle decompression
trakea
IV
Circulation: HR,
tekanan darah, Monitor
perdarahan, suhu
Cairan
INTRO TO CODE BLUE
SECONDARY SURVEY
Secondary Assessment Action
Survey
Pengkajian sistematis History (SAMPLE) Investigasi
Signs and symptoms
Allergies Diagnosis banding
Medications
PMHx Treatments
Last oral intake
Events prior

TTV

PengkajianHead-to-toe
NTRO TO CODE BLUE
EARLY CPR, EARLY DEFIBRILLATION
INTRO TO CODE BLUE
ARREST RHYTHMS

VF
Only 2 “shockable”
(defib) arrest rhythms

Pulseless VT

Asystole Other arrest rhythms,

including asystole
and PEA, should
Everything else with NO pulse is
PEA (Pulseless Electrical Activity) PEA NOT be defib
INTRO TO CODE BLUE
CODE BLUE ALGORITHMS
Pulseless VT, VF
SHOCK 2min CPR
Rhythm/Pulse SHOCKEPI 2min CPR
Rhythm/Pulse

Asystole, PEA
Nothing 2min CPR
Rhythm/Pulse Nothing EPI 2min CPR
Rhythm/Pulse

Shockable (Pulseless VT, VF): try 2 shocks before EPI

Non-shockable (Asystole, PEA): may give EPI early
1:10,000 EPI 1mg IV q4 min
INTRO TO CODE BLUE CODE BLUE EXAMPLE
No response, not breathing
Rhythm Pulse Assessment Action
VT None Pulseless VT arrest Start CPR
200J shock/defib
2 minutes of CPR

VF None VF arrest Resume CPR

200J shock/defib
1mg epi 1:10,000 IV
2 minutes of CPR

Asystole None Asystole Resume CPR

No shock/defib
2 minutes of CPR

Bradycardia None PEA Resume CPR

No shock/defib
1mg epi 1:10,000 IV
2 minutes of CPR