Codes in the OR

Was curious about the code policy (cardiac arrest) in the Operating Room at other institutions. We are in the process of revamping our yearly competency/code management program.....what are your protocols in your hospital OR?

- Do you call a code? or not call a code and deal with it internally?

We keep it internal, but overhead page in our department only for "anesthesia STAT"

- Is ACLS certification mandatory or optional for nurses

Optional for everyone except open heart nurses

- Do you have specific roles/protocols for each team member?

We have specifics for a few:

surgeon- continue operating or at least get to a point to stop if possible

surg tech- maintain sterile field, assist with compressions if chest is draped

pt care asst- compressions if not sterile

RN who comes from outside the room- document

anesthesia- meds, airway

On day shift, we get quite a few extra bodies, sometimes to the point we need to kick people out. Nights, sometimes we have to call PACU for help

- Who runs the codes -anesthesia, surgeon?

Usually anesthesia

- Who responds to your code?

Free nurses/STs, CRNAs, anesthesiologist, pt care asst

- pediatric codes - any info

The only peds anesthesia STATs have been airway issues, so not really

-DNR (Do Not Resusitate) status... remain intact during OR?

Typically DNR goes away unless there is a big, big discussion. This relates mostly to anesthesia giving reversal drugs. Plus, most of our surgeons won't operate if DNR isn't waived, to be reinstated as soon as patient leaves PACU or sometimes later.

- Dealing with family members

Surgeon's responsibility at end of surgery or end of code if unsuccessful. The nurses are too busy with taking care of the patient to be going out to talk to family, although once in a great while during day shift the supervisor for the specialty involved will talk to family.