[justrissy]

HI
I am a 3rd semester nursing student and am working on a paper on codes and the team members involved in a code. My questions are:
What should the 1st person resonding to the code do until others arrive?
What should the second person arriving do to assist the 1st?
Who are the members of a code team and what are their roles?

I would welcome any help

[arpeggiated]

Fetch the crash cart? lol.

ABC's come first.

[BamaFlightRN]

Originally Posted by justrissy

HI
I am a 3rd semester nursing student and am working on a paper on codes and the team members involved in a code. My questions are:
What should the 1st person resonding to the code do until others arrive?
What should the second person arriving do to assist the 1st?
Who are the members of a code team and what are their roles?

I would welcome any help

The first person responding to the code should be sure good QUALITY CPR is in progress. If not, that is their first priority. If so, then they should place the patient on the monitor and look around for what the patients needs are next. For the patient without a IV, he needs one. The drugs we anticipate given should be gathered and made ready, flushes included. The second person in should take over the first nurses responsibity so they can lead the code, being sure the CPR is quality, the people in the room are doing what they should be doing. They need to be monitoring time and cycles of CPR, preparing the things that require interrupting CPR so that a pulse checks they can be done to minimize CPR interuption.

The people that should be in the code...Leader, preferrably a competent ACLS trained physician. 2 people whose sole responsibility is CPR, swaping chest compressor at the 2 min cycles. Need an Medication nurse to administer the drugs and keep in mind the intervals for the next drugs to be given. You need a transciption nurse to chart the code events. Someone competent in airway control, ie CRNA. Too many people in the room can be a hinderence so security outside the room is imperitive also.

Hope this helps.

[TazziRN]

Don't forget the primary nurse, to be able to answer the doc's questions, and a runner.

[S.T.A.C.E.Y]

This is from the Policy & Procedure Manual at my hospital:

1st Person
•Calls for assistance
•Initiates “Code Blue”
•Accesses the Disposable resuscitation bag (BVM device)
•Positions patient in supine position
•Ensures airway open
•Delivers two manual breaths at 1 second per breath to patient using the BVM device
•Assess Assists for chest rise and fall during delivery for 1st breath; if not adequate, repositions head and reattempts manual breath
•Performs the following until code team arrives:
•2 manual breaths at 1 second per breath
•30 chest compressions
•5 cycles of 30:2 compressions: manual breaths is completed (approx. 2 minutes) and carotid pulse is rechecked

2nd Person:
•Brings the Cardiac Arrest Cart to Code
•Sets up oxygen and suction
•Inserts CPR compression back board
•Places respiratory intubation kit at head of bed
•Inserts oropharyngeal airway
•Ventilates using BVM device
•Assists with compressions
•Compressions/ ventilation =30:2

3rd Person:
•Pulls bed away from headwall
•Clears unnecessary equipment from room
•Completes documentation on the CPR record
•Prepares IV and initiates if necessary

The following response team members will respond to a “Code Blue” arrest:
•Code Blue Team Members
•Registered Nurse assigned to care of the patient
•Registered Nurse Resource Person/ Charge – from the area where arrest occurring
•Registered Nurse from Critical Care Unit
•Registered Nurse from Emergency Department
•Vascular Access Team Nurse will attend if on site
•RRT – on call for codes
•ECG Technician (delegate)
•SPD Technician/Porter

Code Blue Physician Team Members:
•Emergency Physician
•Internist on-call
•Anaesthetist on-call
•Most Responsible Physician (MRP) if available


NOTE: For ICU/ER: the 2 RN’s are from the respective areas will respond: therefore, if Code Blue in ICU, ER RN will not respond and if Code Blue in ER, ICU RN will not respond.

Registered Nurse assigned to care of the patient
a)Assumes documentation of the arrest activities upon arrival of the Code Blue Team
b)Provides information on patient status/history

Resource Person
a)Brings chart to bedside
b)Remains in vicinity to assist as needed
c)Liaisons with Critical Care area, etc.
d)Notifies Most Responsible Physician (MRP) or designate

RNs from ICU and ER
a)Initiate advanced Code Blue Procedures: attach to monitor, initiate Medical Directives as indicated
b)Initiate IV, as indicated
c)Assist with medications, intubation, CPR
d)Administer medications as ordered
e)Ensure accuracy of documentation at the end of arrest activities – signs CPR Record.
f)ICU Nurse to facilitate transfer of Patient to the ICU
g)ICU Nurse is to stay with the patient till transfer
h)ICU Nurse will ensure that the Code Blue rhythm strips are reviewed and mounted from the defibrillator.

Emergency Physician
a)Responds to Code Blue as per Emergency Procedures, Code Blue (attends all codes)
b)Is designated “Physician in Charge” until Internist on-call assumes responsibility

[justrissy]

Thank-you all this is all great info and will help me complete my paper!!!

[Larry77]

Originally Posted by TazziRN

Don't forget the primary nurse, to be able to answer the doc's questions, and a runner.

I don't know how many codes I've been to where the primary nurse takes off when the code team gets there--um hello, WHAT HAPPENED HERE? or WHERE'S THE CHART WITH THE MOST RECENT LABS?

I think they take off from an uncomfortable situation and think "phew the code teams here, I'll get out of the way". I don't think this is on purpose but merely an education issue.

[meandragonbrett]

If in the ER, our ER team takes care of it. Otherwise it's ICU nurses, RT, and the intensivist that is inhouse.

[TraumaICURN]

Originally Posted by Larry77

I don't know how many codes I've been to where the primary nurse takes off when the code team gets there--um hello, WHAT HAPPENED HERE? or WHERE'S THE CHART WITH THE MOST RECENT LABS?

I think they take off from an uncomfortable situation and think "phew the code teams here, I'll get out of the way". I don't think this is on purpose but merely an education issue.

I think Tazzi was referring to having the primary nurse there to answer the doc's questions and also having a person as a runner to get needed supplies....Not the primary nurse being a runner.

[Larry77]

Originally Posted by TraumaICURN

I think Tazzi was referring to having the primary nurse there to answer the doc's questions and also having a person as a runner to get needed supplies....Not the primary nurse being a runner.

LOL...If your being sarcastic that's funny...If not, I knew exactly what Tazzi was talking about--just sharing my experiences