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Code Blue, Code Blue!!!! Whats a nurse to do? Unit V.

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Presentation on theme: "Code Blue, Code Blue!!!! Whats a nurse to do? Unit V."— Presentation transcript:

1 Code Blue, Code Blue!!!! Whats a nurse to do? Unit V

2 Objectives Discuss cardiac emergency to include the use of the crash cart and the importance of BLS Identify Rapid Response Team and Code Blue Team

3 Patient Emergency 50 % patients who code exhibit warning signs up to 6 hrs prior to arrest RRT consists of ICU nurse, RT, sometimes MD, and bedside nurse RRT at bedside within minutes to assess patient

4 Criteria for calling RRT Change in heart rate ( 130) Change in Systolic BP ( 200) Change in resp. rate ( 24) or threatened airway or change in SaO2 Change in mental status New, repeated, or prolonged seizures UO <50mL/4 hours Failure to respond to treatment to an acute problem/symptom Nurse, patient, or family member is concerned

5 What to Do I Do If I Think My Patient is in trouble? Tell nurse responsible for patients care (also clinical instructor) immediately of changes in patients condition Rapid Response Team (RRT) team – can be called as soon as the nurse identifies changes in the patients condition Reassess the patient frequently

6 Calling Code Blue Determine unresponsiveness Call out for help Push Code Blue button at the head of bed or Pick up the phone and dial______ Identify the emergency – Code Blue Identify the location and the room # Note time using the clock in patients room

7 Prior to the Code Team Arriving Start CPR Circulation Airway Breathing Defibrillation (AED only) Obtain the Crash Cart/AED Remove extra furniture from the room Unit Secretary will: Page Chaplain for Family support Call attending MD Chart to Room

8 Once the code team arrives Do not stop CPR when the first team member arrives Continue until someone is ready to take over

9 Code Team & Their Roles Hospitalist or ER doctor– team leader – intubation, gives orders Critical Care Nurse – gives meds Supervisor / Staff nurse – documents Respiratory therapist – assists respirations, may intubate as well Lab – ABG, BMP, CBC NA –CPR, brings crash cart and chart, help with other patients Chaplain - assist with taking family to quiet location Student – CPR, observation

10 What the Code Team Needs to Know Current Diagnosis / Recent Treatments or Procedures Events Leading Up to Code Recent Meds Primary MD Code Status Other Pertinent History: Allergies, MRSA Status, Diabetic, Cardiac, respiratory history, etc.

11 Post – Code Responsibilities Patients nurse gives report to receiving nurse Family Care Code Summary printed EKG Strips charted Completed Code Sheet signed by physician in charge of the code Code Evaluation completed and sent to Risk Management Cart Exchange Documentation

12 Patient assessment ECG rhythm (strip) Notification of MD, orders received Treatments initiated & patient response, post treatment rhythm (strip) If transferred, mode of transport, transfer note, receiving unit bed number, receiving nurse

13 The Crash Cart Top 1. Defibrillator 2. Intubation equipment 3. Possibly meds O2 tank, portable suction, ambu bag Front drawers and Side drawers 1. Meds 2. IV equipment + fluids 3. Resp supplies 4. Trays 5. Misc (gloves, sutures, flashlight, batteries) Example

14 Emergency Medications Oxygen Epinephrine Amiodarone Atropine Adenosine (Adenocard) Diltiazem Digoxin Lidocaine Magnesium Sulfate Dobutamine Dopamine Narcan

15 Do Not Resuscitate Full code or No Code Documentation on chart of MD order MD discussion with patient / family Chart labeled MAR labeled What if family changes their mind??

16 Students Role in a Code Assessment / reassessment Notify nurse immediately of changes in the patients status Perform CPR Observe during the Code Help with patients family

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