Code Blue Documentation

I work in critical care, for code blues, our monitor tech usually runs a continusous strip for the code...initial rhythm is then posted, as with any significant changes/slowing down/speeding up/defib/cardiac massage/any obvious change after meds...

During a code the monitor runs continuously, we just wind up the entire strip to stay with the code sheet. I usually run a strip at the beginning and end of the code for my flow chart records.

The one problem with just winding up the entire strip is that if the information were to be photocopied, the entire wound up strip would not be copied.

I am in CICU. We have a full disclosure monitor that records and remembers the entire events. So it is a safety feature for us, it can also be recalled. The defibrillator also prints the entire event and we can also print strips from the monitor. Initial rhythm is posted, first defib intervention, as well as anything grossly signifigant, then the rhythm after the code ceases....

Our pharmacist comes to all codes and records for us...including meds given, cpr, when pulse is present, defibs, etc, etc. They also obviously draw up the meds...

Most newer monitors/defibs have a code summary option that prints it all at the end which notes "shocks" and changes, it depends on the situation. When we get full arrests who are asystole or pea on arrival and nothing changes and the code is terminated, two or three strips will suffice for us. If anything changes on the rhythm i usually run a strip and hand it to our recorder.

Our new monitors have the code summary. It's made life a whole lot easier.

At most facilities, there is a policy regarding Code Blue documentation etc. If your facility does not have a policy then in my experience we would post a strip (original rhythm) and then everytime the rhythm would change, post defib, and post-resuscitation meds. If there is time, it is extremely convienant if ONE nurse can take the time to do the strips, while the other one finishes/completes the documentation.

When I run to codes with the defib, I usually run a being code strip, and a significant event code strip, like defib etc, and then a strip about every 2-3mintues. Then I usually give the strips to the receiving ICU nurse or the patients nurse on the floor. I do not place the strips in the patients chart personally, as I do not have the time. With tele and ICU patients, they are continously monitored, so they are recorded anyway.

The code recording RN writes down the rythmn also throughout the code, so there is plenty of documentation.....

Remember, always chart like the next time that you will see that chart will be in a court of law. The best charting is due to common sense and what a prudent RN would do. Also, remember to consult what YOUR particular institution already has in place as far as policy and procedure. In a court of law, the state that you practice will have a Nurse Practice Act, but lawyers love to bring hospital policy and procedure into account ALONG WITH national/regional standards of care.

Also, it depends on if you are speaking of a "code team" responding to a floor code which is COMPLETELY different than when an unknown presents into the ED.