Who's on First
The HAA nurse's role when assigned to the Code Blue team and a code is called.
What is:
-Attaching leads and defibrillator pads
-Attach 02 sat probe and blood pressure cuff
-Obtain IV access is not already done
-Begin scribing if on 4F/HAA
-Performing v/s and assessments of ABCs and reporting changes on an ongoing basis
-airway management until RT arrival
-compressions as needed
The recommended rate of compressions, depth of compressions and ratio of compressions to ventilations with 2 rescuers for a child before an advanced airway is placed.
What is 100-120BPM, 1/3 the diameter of the chest (5cm), 15:2?
A useful resource for supporting family members during a code blue.
Who is a social worker?
The steps to take when a STAT medication is not available on the code cart or drug back-up bag (i.e. ketamine, succynilcholine)
What is:
1) Check 4F pyxis
2) If regular hours, call Pharmacy and have it delivered STAT (specify for a Code Blue)
3) If after hours, perform a Pyxis global search, locate the dept. and retrieve it STAT
Bedside charting by a colleague should be initiated at this time.
When a patient begins to show signs of instability and frequent interventions are occurring?
The first step (after calling for help) when encountering a child who is unresponsive and not breathing on 4F.
What is starting compressions and rescue breathing?
This is the best initial oxygen delivery system to use when your patient is displaying worsening respiratory distress and showing signs of decline.
What is a non-rebreather?
On the back of the crash cart.
Where is the back board?
Create a temporary profile in Pyxis (by going to "remove" and then "add patient") and override as needed.
What to do if requiring drugs from the Pyxis in a Code Blue situation and there is no profile yet created?
The best location for the scribe to be positioned in the room during a code.
What is the space next to the Code Captain, ideally at the foot of the patient's bed?
The duties of the 4F nurse when her patient codes.
What is:
-call for help and start compressions and rescue breathing
-provide detailed history to each member of the code blue team as they arrive (this may need to be done multiple times)
-assist with tasks, interventions and assessments
These 2 rhythms are shockable and these 2 rhythms are not.
What are pulseless VT and VFib; and asystole and PEA?
The first drawer on the Crash Cart.
Where is the simple airway drawer?
This drug requires rapid administration followed by an immediate NS flush.
What is adenosine?
An approved and organized way of documenting a pediatric code blue in addition to the Code Blue Record flowsheet.
What are progress notes with health region letterhead?
The best thing to do when alone with an unstable patient and a doctor asks for an intervention (IV medication, fluid bolus).
What is call a colleague for help by yelling out the door and pulling call bell out of wall?
This should be initiated with a HR less than 60 and poor perfusion in a child or infant.
The drawer in which the 4-way stopcock is located.
What is drawer 5 (IV & IO supplies)?
During a code, this is always required when administering medications and blood products.
What is an independent double check as needed, safe dose and patient identification?
The role of the scriber includes these 4 things.
What is:
-filling out the code blue record
-cueing pulse checks and medication delivery (i.e. epinephrine) in cardiac arrest
-providing ongoing summary of events
-ensuring the code blue record is signed by all participants after the code
The person who brings the code cart to a code on 4F and clears the room (i.e. remove unnecessary equipment and furniture).
Who is any nurse available?
This is the most important thing to do immediately before defibrillating or cardioverting an infant or child.
What is state "I'm clear, you're clear, we're all clear, oxygen clear"?
The salbutamol monograph is located here.
Where is the HAA medication reference binder, and in our "HAA pediatric preparation tables binder"?
It is important to know the delivery method of an IV medication (IVD vs Intermittent) when preparing non-critical medications because this might be different.
What is the drug concentration/dilution amount?
This form must be filled out by the Charge Nurse after every code called on 4F and HAA.
What is the Pediatric Code Blue Debriefing Form?
NOTE: This must be filled out within 30 minutes, and is given to our manager. This form is confidential.