Code Blue in OR

[Gottago]

While a patient is in the OR, and the patient becomes a code blue, who pushes IV meds in your facility, CRNA or Circulator?

[Rose_Queen, BSN, MSN, RN]

When we have a code blue in the OR, we usually have an over abundance of anesthesia providers arrive unless it is after 11pm. They take responsibility for pushing meds while the circulator documents or runs the defibrillator if the charge nurse arrives to take over documentation.

[jwk]

Not sure why anyone would abdicate that function to the circulator. Unless they're cross-trained for PACU, most are probably not evem ACLS certified. They don't push drugs any other time in the OR, so why do so at the most stressful time? Ours bring in the crash cart, get more help, do CPR, etc.

[subee, MSN, CRNA]

A lot of OR nurses don't even know how to open and assemble a cardiac lidocaine. Unless is after midnight and no one else is available, anesthesia does it.

[TraumaORnurse]

Anesthesia always dictates the drugs given and pushes them. We have drug carts in each OR so they call pull what they need, then will call out when they push something for an RN to document on the code sheet. If it's during the day or evening we call pharmacy & they will come to assist, often pulling & prepping drugs in anticipation.

We have Trauma Anesthesia in house not working unless they are doing a trauma so we call them immediately. Also during the day we page out a code in progress to Anesthesia so any who are available come to assist.

As for the comment about ACLS nurses, a fair number of our OR nurses, myself included, are ACLS certified and several PALS certified.

[MereSanity]

Wow...I'm an OR nurse who is ACLS, and PALS trained, I push meds, hang drips, my anesthesiologists all trust me, I assist placing triples and swan ganz caths, I also work open heart but could do that before I joined open heart. Most people think OR nurses are glorified "gophers" (and some are) but many are awesome. It doesn't mean OR nurses have lost their skills....we just have DIFFERENT skills. The OR isn't for everyone and most can't hack it. There are hundreds of different instruments and pieces of electrical equipment you must know inside and out. But holding a heart in my hand for an hour while the surgeon works on it....so stinking awesome. Yeah, I forget how to start an IV but I can handle a code in the OR no problem....and I push meds while anesthesia takes care of more important stuff...like the airway....no...you couldn't PAY be triple to work the floor!

MereSanity BSN, RN, CNOR

[Spode]

Are you serious? ALL "codes" (which are never "called") in the OR or anywhere else for that matter are due to hypotension or hypooxemia.

You had better hope MDA or CRNA is on it BUT this does not mean the most educated is up to date!

[MereSanity]

That's right...OR codes are handled by the OR and other departments rarely respond due to the fact that it is a sterile environment.