Role With It
Who is qualified to do compressions?
Anyone with BLS
The coding patient is not intubated. What is the algorithm for ventilations and compressions?
30 compressions, 2 breaths
Who is qualified to put the pads on the patient and run the defibrillator?
ANYONE
Scenario:
Patient is unresponsive. How long and where do you check for a pulse?
10 Seconds; Carotid or Femoral
What process should occur after each code to evaluate the unit's response and opportunities for improvement?
Code Debrief
What type of Nurse can push resuscitation medications?
RN
As ventilator, what can you do to help the compressor?
Count out loud the compressions and ventilations
Do you continue compressions while the AED is charging to shock?
YES
Scenario:
The patient is in v-fib and first shock has been delivered. What is the first medication you push and how soon should it be given?
Epi given within the first 2-3 minutes of the code
This is the type of communication needed during a code
Closed loop communication
In a code, who has to be ACLS certified
Charge Nurse
How should you respond:
Your patient has <85% SPO2 for more than 5 minutes
Call a Rapid Reponse
If you are operating the defibrillator, where should you be looking when delivering a shock?
Visualize your field
Scenario:
How often can epi be given during a code?
Every 3-5 minutes
What should you verbalize when clearing the field to deliver a shock to the patient?
CLEAR, CLEAR, CLEAR
As Charge Nurse, what is your goal for the primary nurse during a code?
To have them in a role where they can communicate about the patient, such as med nurse
What changes with ventilations when an advanced airway is placed during a code?
Continuous compressions and ventilations
Do you compress the patient while analyzing their cardiac rhythm?
No
Scenario:
You patient has a hairy chest. You use the chest pads to remove the hair. Where do you locate the set of back up pads to place on the patient?
Drawer 3
If you are not able to deliver high quality compressions for the full two-minute period, when should you verbalize the need to switch?
Verbalize the need prior to stopping compression and coordinate the switch during a round of ventilations
What tool is available to our Charge Nurses to help track timing of interventions such as medication doses and pulse checks?
Full Code Pro app
Your patient has a pulse now! As the ventilator, what do you do??
Keep ventilating the patient
At what point should you analyze the patient's initial cardiac rhythm?
As soon as the chest pads are placed on the patient.
Scenario:
In a code, beyond the basic interventions, what else should be considered?
The cause of the code
-H&Ts
In a chaotic code situation, what are the primary interventions a charge nurse can do to create a cohesive environment?
1. Own Your Role
2. Lead by example - set a calm tone
3. Reduce noise
4. Crowd control
5. Clarify assigned roles and have unassigned staff go back out on the unit