Roles
What is the role of the Gen Med nurses on the Code Team?
BLS- CPR, BVM. Can apply pads and assist with LUCAS application.
Name the shockable rhythms.
Pulseless V-tach and V-fib
Your patient has a BP of 70/32 with a HR of 168. They have decreased LOC. What would you anticipate doing?
Synchronized Cardioversion.
You give this medication to speed up a patients HR, but it doesn't work if your patient is in a block. Give medication name and dose.
Atropine 1mg bolus repeat every 3-5min
How do you call a code from the PACU?
Dial 71 and say 3 times over the intercom "Adult Code Blue PACU" or "Pediatric Code Blue PACU." If no response from code team after 2 min page again.
Name some of the "Value-add" members of the Code Team.
THE AMAZING PACU NURSES, anesthesia, SW, CNE, Lab, Medical Imaging.
What rhythms do you not shock?
Asystole, PEA.
You have given your patient atropine with no effect on increasing their HR. What intervention would be next if they are unstable?
Transcutaneous pacing
This medication is given for stable tachyarrhythmias.
Adenosine 6mg rapid IV push followed by 20ml NS flush. Repeat dose at 12mg if required.
What is the CPR breaths to compression ratio for an adult patient without an advanced airway?
2 breaths to every 30 compressions.
Who is responsible for keeping track of time?
The recorder/documenter.
Describe what constitutes "Good" CPR...
Pushing hard and fast at least 5cm at a rate of 100-120 compressions/min and allowing for complete chest recoil.
What technique might you try for a stable narrow complex tachyarrhythmia?
Vagal Maneuver like having the patient blow into a syringe and then placing them supine with their legs elevated above their heart for 15 seconds before sitting them back upright.
What 2 medications do we give for for shockable rhythms resistant to defibrillation?
Amiodarone and Lidocaine.
What is the compression to breath ratio for a pediatric patient?
15:2
There is a Code Blue in IPPU. Which crash cart will be brought and by whom?
The crash cart from 2 South will be brought by 2 South staff.
What does and frequency of epinephrine is given during a code?
Epinephrine 1mg/10ml IV push every 3-5min
Your patient is in V-Tach but has a pulse. The doctor asks you to prepare Amiodarone. What dose would you anticipate preparing?
Amiodarone 150mg diluted in 100ml of D5w given over 10min.
This medication is given for anaphylaxis. What dose and route is for adult patients.
Epinephrine 0.5mg IM to the vastus lateralis muscle.
How do you dump a charge on the Lifepak?
Press the grey button in the speed dial.
There is a Code Blue in the MRI trailer. Which crash cart will be used?
MRI is considered an outside of the hospital code so EHS must be called and it will be a BLS response. The MRI trailer has an AED and a BVM.
You notice your colleague is performing CPR too fast to allow the chest to recoil. What would you do?
"Betty you're compression too fast, please slow down a bit to allow the chest to completely recoil." Could use the CPR metronome on the Lifepak. Switch compressors.
Your patient remains bradycardia after giving atropine. The doctor asks for you to mix an epinephrine infusion. How would you mix this?
Dilute 3mg of the 1mg/ml epinephrine vials in 250ml to equal 12mcg/ml.
What dose of Amiodarone is given for pulseless VT?
300mg IV bolus for initial dose. 105mg IV bolus for second dose.
Your patient has an advanced airway in place. How often do you give a breath?
1 breath every 6 seconds = 10 breaths/min with continuous chest compressions.