Question on roles in code

[nursingchick111]

Hello

How do all of you feel about providers leaving a role randomly or getting distracted out of roles during a code (except for compressions or extenuating circumstances)?

Thank you.

[emtb2rn, BSN, RN, EMT-B]

Need more details.

[Sun0408, ASN, RN]

Agree. More details are needed

[MYSTICOOKIEBEAR]

One thing that you must remember is that there is ALWAYS something to do in a code. It doesn't matter how many people are there, there is always some way you can help. In the codes that we have in the Cardiac/Transplant ICU we have many positions that need to be filled but this is it for the most part:

-Primary RN @ head of the bed pushing meds

-Compressions

-Pads and defibrillator

-100% ETT Bagging (until RT gets there)

-Crash cart meds (until Pharm gets there)

-Rapid transfuser and/or pressure bagging fluids or blood products

-In room supply preparer

-Runner (supplies, meds, tubing etc)

-Scribe and timer

Now that you see all of the positions, you have to then realize that codes are very fluid in nature. You might now always have all of the support that you need so 1 RN might have to do multiple roles at the same time. Sometimes I will be med pusher or rapid transfuser and see someone on the chest doing piss poor compressions, I will literally say "Mary, I am swapping out with you in 10 seconds, you are going to take over meds" or "you are on the rapid". As long as the key roles are accounted for, you should be in pretty good shape.

The thing that makes codes run smoothly is if you appoint one person to call the shots until the code team MD or primary MD comes. Another thing that will make things infinitely easier is if you call people out to do certain tasks. Rather than saying "I need a flush" or "I need some tubing and a pressure bag" say "Liz, I need a flush" or "Liz I need some tubing and a pressure bag". When you yell out for random things, people will always assume someone else will get it. Be direct, be concise, and prepare for the worst.