Code Blue Announcement

[airborneinf82]

So just wanted to get some thoughts from other people here. The hospital I work for has just announced that they will no longer overhead page code blue's with the room number. Instead (as is currently in place) a pager (beeper) system will be used to alert people to respond.

Does anyone else work in a place that does this? I think the main reasons cited for the change are pt/families concerns with the anxiety of thinking it is their family member and also HIPPA violations. I don't really see much case for the HIPPA violation and I think doing it to appease families is the wrong reason.

Here's my biggest concern. FIrst off my floor is split on 2 wings and without an overhead page people on one wing would be clueless to what is going on with the other side, meaning less help to get there within the first 10-20 seconds. Secondly, and sort of inline with my first concern is that the studies show that if someone is VF or VT that if they can be shocked within 2 minutes as opposed to even 5 minutes, the outcome is drastically improved. I guarantee it takes longer than 2 minutes (even on our telemetry floor) to notice someone is in a lethal rhythm and to sound the code, have the paging system go off, and for people to get to the floor from other floors.

At least with the overhead page, you can get the experienced floor personel to the room quickly and can get to patient prepped with the pads and start analyzing the rhythm to get them shocked asap if need be.

I don't know. I don't think anyone likes the idea, including the docs I"ve talked to. What do you guys think?

[RNsRWe, ASN, RN]

I can see how, in larger facilities, overhead pages would be disruptive. In our smaller, 120 bed facility, we *need* the overhead page. If I hear a code blue called overhead, I know that I can't call the ED, ICU, or nursing supervisor to assist with a particularly hard stick...the extra staff are all in the code. I'm not going to call the ICU charge nurse to ask a non-urgent question, and I'm not going to call the nursing supervisor to ask him to go down to central supply and get me SCDs for my new admit.

Excellent point, and one I forgot when writing my own post. Everyone hearing "code blue" also meant we knew who NOT to call for the next half hour to an hour.

[canned_bread]

At my hospital, if we press the duress button on the wall a different beep sounds to the normal call bell beep and on the signs throughout the unit it flashes in red the room number and the word duress ie "BED 22 DURESS". That means, everyone on the unit attend NOW. When a MET call (medical emergency team) is called ie if someone has crashed, the assigned people in ICU get a page to their pager to come down to the unit. The pager also makes a different noise so they look at it straight away. To get the MET page out, we dial 444 (from any phone, even the one beside the patients bed) and state unit, bed number or area, and what has occurred.

I think it would be ridiculous to not have the unit duress beep. With our current system we respond very quickly if on the unit and someone brings the crash cart, and when the ICU team/MET comes down it never takes over 6 minutes for them to arrive.

[amoLucia]

Back in the dinosaur days, I remember a lot of concern when a code would be announced over the pager where-ever (6th floor, 3 west, ICU, etc). Nose-y visitors from all over the house would flock to the area for a look-see, neighboring pts would become upset (there is some bonding concern among pts on a unit), family members who were out of the area briefly would return PANIC-stricken, etc. Lots of staff would show up also. It was a very real public 'spectator sport' needing crowd control.

Today's electronic tech toys seem to be the going thing but not without functional & operator issues. I guess there's no win-win anywhere.

[Ayvah, RN]

This is an issue that greatly bothers me. As many people have already stated, overhead code announcements have allowed us to help neighboring units with their codes, know which units not to bother with requests/questions that can wait, and helps get the information to all available people ASAP, 100% of the time. I remember the time I was in a utility room far from my patients, heard an overhead announcement of a code blue which happened to be right next to me, and was the first RN to respond. Had the system been instead individual pages, I would NOT have gotten informed, and the code would have been delayed. Those additional hands and additional seconds of care are so important.

I worry how the ever increasing mentality of hotel/fluff/appearances impedes the care of our patients - this is a prime example and it honestly sickens me. A patient's life is more important than anything else.

I wonder, for those who use this type of individual pager system, does this mean the other codes such as for violent persons are not done overhead either?

[xoemmylouox, ASN, RN]

Well getting people to respond to a code is a challange in itself sometimes. I hate to imagine what it would be like if our facility used pagers. No thanks.

[DroogieRN]

My old facility called Code Blue overhead followed by a scrambled four-digit number, which everyone knew how to decipher as unit and room. I thought it worked pretty well. New facility calls Code Blue overhead with unit only, and select personnel have pagers that give more detail. That seems pretty efficient too.

[turnforthenurse, MSN, NP]

We have an overhead pager system where I work. The code blue alarm will go off and they will announce "code blue" along with the room number. Our rapid response system goes via page...the nursing supervisor has one along with one RT and one ICU RN.

[Lovelymo79]

I'm in the ICU and just responded to a code last night. My hospital uses the "Dr." code for different situations. "Paging Dr. Blue" is an adult code while "Paging Dr. Red" is a fire and etc. Location/unit and room number is given. There is a pager but the girl that had the pager was dealing with an emergent situation in her room. Because I was willing, I went and she didn't even know. It doesn't matter who has the pager bc anyone from our unit can go. If she had to call out that the pager went off and then tried to tell us where it was would have wasted precious time. I heard everything I needed to know as I ran through the halls.