Scribd
Upload
11 views

Code Blue Policy

Uploaded by

dr.eyad.m.m.m
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
11 views

Code Blue Policy

Uploaded by

dr.eyad.m.m.m
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

CODE BLUE POLICY

If the patient is unresponsive: -


Check the carotid pulse along with the chest movement and breath sounds for 10 seconds if there is
no pulse: -

1- activate the code blue.


2- start chest compression and respiration by the attending physician and nurses at the rate of 30
chest compression and 2 breathing by bag- -valve masks attached to oxygen after opening the
airway.
 Regarding chest compression

It should have a depth of 5- 6 CM with full chest recoil between each compression.

 Regarding ventilation

Opening the airway with the head tilt chin left or jaw thrust, use airway adjuncts or oral airway or nasal
airway then start ventilation by bag valve mask and do a proper seal with C and E technique then attach
the bag valve mask to oxygen with reservoir.

3- when the team arrives

The patient is attached to the monitor and there is a brief pause to check the Rhythm on the monitor.

 shockable rhythms like ventricular fibrillation or pulseless ventricular tachycardia

Immediate DC shock at the rate of 200 to 240 joules without delay

- The protective gel in the body of the patient should be applied, and then apply the pads over it.

position of the pads: One over the right of the upper sternum just below the clavicle and the other one
at the meat axillary line add the side of V6 should be free from breast tissue.

Aftershock immediately resume chest compression and ventilation.

 Non-shockable rhythm like asystole, and PEA resume the chest compression and ventilation,
starts adrenaline IV 1 milligram of adrenaline 1:10000.
4- check the rhythm on the monitor and the pulse of the patient every two minutes.
5- if the shockable rhythm is continuous: -
 Give adrenaline just before the 3rd shock.
 After the 3rd shock give amiodarone: - the 1 st dose is 300 milligrams, the 2nd dose is 150
milligrams intravenous or IO or lidocaine 1st dose is 1-1.5 milligrams /KG, the 2nd dose is
0.5 -0.75 milligrams/KG intravenously or IO.
6- Adrenaline is given 3 to 5 minutes.
7- during CPR consider reversible cause of arrest
 Hypoxia: try to increase oxygen and if ET CO2 is less than 10mmhg consider intubation or using
LMA and be sure not to interrupt chest compression.
 Hypovolemia: starts with fluids and blood as required and can be IV or IO considered
vasopressors.
 Hypo or hyperkalemia: once an intravenous line is obtained send samples and manage as
required.
 Hypothermia: as in the case of throwing a blanket and removal of wet clothes.
 Tension pneumothorax: needle decompression and chest tube placement
 Cardiac tamponade: pericardiocentesis
 Toxins: managed according to the toxin and common cocktail can be given
 Thromboembolism: alteplase should be given AS FOLLOW: -
 1- Myocardial infarction: 15 milligrams intravenous bolus then 0.75 milligrams per KG infusion
over one hour
 2- pulmonary embolism: 100 milligrams over two hours intravenously or 50 milligrams for 15-
minute intervals 50 milligrams intravenously.
 Once suspected: CPR should continue for not less than 45 minutes until the effect of
thrombolysis.
 Analysis of pulseless electrical activity to recognize the cause of arrest.
 If arrow QRS pulseless electrical activity it means right ventricular problem, left ventricle is
hyperdynamic.
 The right ventricle may be dilated due to pulmonary embolism the management here will be
thrombolysis.
 If collapsed due to tamponade, tension pneumothorax, mechanical hyperinflation if attached to
a ventilator.
 if wide QRS pulseless electrical activity it means the left ventricular problem, the left ventricular
is akinetic or hypokinetic due to severe hyperkalemia the management will be calcium chloride.
 Sodium channel blocker toxicity management will be an HCO3 intravenously.
 Continue CBR for not less than 30 minutes or tell the team is extremely exhausted.
 if the shockable rhythm exists, CPR must be continued
 If ROSC is achieved
1- Recheck ABCDE and stabilize each one.
2- 12 leads ECG, chest X-ray, shift the patient to ICU.
Rules of the team during CPR: -
1-The team leader: he will be the ED consultant or ED registrar if they are on duty, if not the ICU
specialist will be the team leader.

2-the ICU doctor to manage the airway

3-Nurse #1 helps the ICU doctor with airway

4-Nurse #2 obtained an intravenous line and gave orders regarding intravenous medication and fluids

5-nearest numbers three and four are responsible for chest compression and attaching the patient to
the monitor

6-cardiologist internal medicine or anaesthetist is possible for DC shock and assistance with chest
compression as well as help the nurses with intravenous line and medication.

7-Supervisors nurse responsible for the time and recording

8-Pharmacists to repair the needs of the drugs.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy