Code management

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Code BlueCardiac Nursing Care

Qaisar Iqbal Shifa College of Nursing

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Objectives • By the end of presentation students will be able to

– State the purpose to using code language

– Describe the mechanism of cardiac arrest

– Explain the importance of primary and secondary

CABD survey

– Explain the treatment hierarchy of code blue

– Describe post cardiac arrest care

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Cardiac Arrest

• Mechanisms– Ventricular Fibrillation– Asystole– Pulseless Electrical Activity (PEA)– Pulseless Ventricular Tachycardia

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Ventricular Fibrillation

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Asystole

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Pulseless Electrical Activity

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Pulseless Ventricular Tachycardia

Code Blue Team

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Compressor

Breather

Recorder

MedicineAdministrator

Team LeaderCoordinator

Runner

Nursing Supervisor

Security

First Responder

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Primary CABD Survey • Focus: Basic CPR and Defibrillation

– Check responsiveness– Activate emergency response system– Call for defibrillator

Circulation Airway Breathing Defibrillation

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Contributing factor

• Hypoxia (CNS events)

• Hypo/hyperkalemia

• Hypo/hyperthermia

• Hypo/hyperglycemia

• Hypovolemia

• Trauma

• Tamponade

• Thrombosis – (pulmonary/coronary)

• Tablets (ODs, drugs, etc)

• Tension pneumothorax

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ETT Drugs

• L = Lidocaine

• E = Epinephrine

• A = Atropine

• N = Narcan

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IV Push Drugs• P = Vasopressin

• L = Lidocaine

• A = Atropine

• C = Amiodarone

• E = Ephinephrine

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IV Drip Drugs• L = Lidocaine

• E = Epinephrine

• A = Amiodarone

• D = Dopamine

• S = Solutions (IV)

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Documentation during code blue

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Post-resuscitation Care

• Suppression of ventricular irritability– If VT or VF converted before lidocaine

given, lidocaine bolus and drip

– If lidocaine or bretylium worked, begin infusion

– Suppress irritability before giving vasopressors

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Pearls of Successive Code Blue• Early identification of arrhythmia

• Early response

• Early CPR

• Early defibrillation

• Early advanced care

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• 20 mls IV push followed by resuscitative medications

• Identifying and treating contributing factors

• Effective team work

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