Does every hospital have a 'code team'?

Katnip, RN · Dec 2, 2003

We don't have a dedicated code team. All nurses in critical care areas are trained in ACLS as well as all the docs and residents. Each critical care area is designated an are of the hospital to where they would respond in case of a code, and nurses will go to a code that's called there.

Example. The ER nurses will respond to codes called on their floor, including the OR (and yes, strangely enough once in a while the ER or cath lab will call an overhead code), and the floor above with is mainly administration and the cafeteria.

CCU or AICU nurses will go to the other floors, which are divided between those two units. Not all nurses on each unit goes to a code. Usually only need one or two, mainly to mix the emergency drugs.

As far as who is on a code team, usually we have a respiratory therapist who takes care of bagging the patient, a doctor is usually the one who runs the code, calling for the different drugs, deciding what need to be done, when, intubation, and calling the code (stopping it). We usually have a surgeon show up to see if we need a central line place.

There is a nurse who records what goes on, which drugs go in when, a nurse to give the drugs ordered, a nurse at the cart who prepares the drugs to be given (most are premixed, but some have to be mixed if necessary), and of course people to do compressions and relieve each other. Compressions in a real code are harder than they look. We usually have a unit secretary or someone who can run for any extra materials that may be need that are not on the cart or the intubation kit.

Of course, the nurse who belongs to that patient is there in some capacity, and needs to be able to give a quick history to the team leader.

Our hospital is a teaching hospital, so when an overhead code is called, you can expect about 40 useless bodies milling around hoping to get a change to participate. Most have to be chased away.

zambezi, BSN, RN · Dec 2, 2003

We have a code team compromised of many people. One nurse comes from ER, CCU, ICU (total 3 RNs). RT/Lab/CXR/Pharmacist/TACHand of course, the ER doc comes. The RNs run the code until the doctor gets there. If a central line needs to be placed, the doc does it.

Our "roles" include: code leader (ER/ICU/CCU RN)

Airway management (RT, RN until RT arrives)

Medication RN (can be any RN but usually one

of the three from critical care)

CPR: usually tech but again can be RN

Cart RN: Hands meds to med RN. Works defibrillator. Grabs supplies, coordinates further care (can also be code leader)

Recorder: RN to record.

Our roles just kind of fall into place when we get there. Nursing supervisor also comes along. Usually there is an abundance of people.

SmilingBluEyes · Dec 2, 2003

Originally posted by zambezi
We have a code team compromised of many people. One nurse comes from ER, CCU, ICU (total 3 RNs). RT/Lab/CXR/Pharmacist/TACHand of course, the ER doc comes. The RNs run the code until the doctor gets there. If a central line needs to be placed, the doc does it.

Our "roles" include: code leader (ER/ICU/CCU RN)
Airway management (RT, RN until RT arrives)
Medication RN (can be any RN but usually one
of the three from critical care)
CPR: usually tech but again can be RN
Cart RN: Hands meds to med RN. Works defibrillator. Grabs supplies, coordinates further care (can also be code leader)
Recorder: RN to record.
Our roles just kind of fall into place when we get there. Nursing supervisor also comes along. Usually there is an abundance of people.

sums up what we do at where I work...I just jump outa the way when a code is called as I am NOT practiced in it. Usually wind up recording or "assisting" on these.

CashewLPN, LPN · Dec 2, 2003

hiya...

hmm... where I used to work(rehab, where the codes were often VERY messy....)

the codes usually broke down like this:

Airway management: Nurse till RT till intubated by surgery intern, then RT

Medication RN : ADN or ACLS Nurse (The ADN's have ACLS, and we were suffering some major nurse abuse from the younger MD's)

CPR: Sub-intern (med student) or Nurse or intern

Code Leader: second or 3rd year intern w/ the resident nearby

Recorder: Nurse (it somehow usually ended up being me...)

Runner/Go-fer: Nurse or Aide... basically, the 'we need this from the med room... go get it' or, 'tell the clerk we need this'

what else, what else... um...

thats it

--Barbara

PMHNP10 · Dec 2, 2003

We sorta do. The problem with my hospital though is that during the night we have often have noone who is allowed to intubate. For some strange reason RT isn't allowed to do it. :confused: So when a code is called we have to hope a resident hits it, but if he doesn't...pray. I think at that point we have to call like the on call anesthesiologist or something:o

meownsmile, BSN, RN · Dec 2, 2003

Our code procedure sounds about like Zambezi's.

TinyNurse, RN · Dec 2, 2003

Forgive me if I sound weird, but I work in a small community ED. We don't really have a "code team" but everyone seems to know what to do........ an ED RN and MD run to ICU if a code is called, and an ICU nurse or few run to ER when a code is called..........

My only two hospital codes have been sorta weird compared to the one i saw precepting my last week of nursing school.

RT is not allowed to intubate at my hospital as well, but a medic can.........

xoxo

Jen

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Dec 2, 2003

We do have a code team that will respond to the code blues on our floor. The pharmacist, ER/Cardiologist, CCU nurse, Flight Nurses, RT, Anesthesia and everybody and their brother respond to the code that is in the 6x10 room.

All of our nurses are ACLS, which we have to know but hate to have to use. On a fairly regular basis we have what we like to call, "non-called codes". This is when they decide to do a cardioversion in the room, or intubate a patient when the primary players are already in the room. Then we have less resources available and the nurses on the floor become the code team.

Tweety, BSN, RN · Dec 2, 2003

We have a code team.

The intern and resident run the code per ACLS protocol

A critical care nurse administers the medications

A resp. therapist intubates

The orderly comes and helps with compressions

The nurse whose patient it is documents

The chrage nurse makes calls and makes sure the floor runs o.k.

The rest of the staff stay out of the way but are gophers

nowplayingEDRN · Dec 2, 2003

When I worked civilian it went like this:

3 Nurses: 1 RN- meds and defibrillation, 1 RN- CPR and 1LPN-record or spell on CPR

1 House MD: Ran the code and intubated if RT could not get it

RT, Xray Tech and Lab

Security and House Keeping

Nursing Supervisor and the nurse for that pt

The last 4 usually ran go-fer

Where I just left:

1 ICU Nurse, 1 ER Nurse (if possible), Anesthesia, Adult or Pediatric MD on Call, 2 medics (EMTs), and 1-2 HN (usually from ICU and ER).

Where I am going now.........I guess I will find out all in good time.

RNKPCE · Dec 2, 2003

CCU RN is code leader til a doctor arrives

TCU Rn is medication nurse

Tele RN is recorder

Resp Therapist - airway managment, bagging etc

Supervisior- talks to family, liason

ER Doc- respond to inhouse codes until pt md arrives.

Patient Nurse- compressions and/or calling doctor, answers questions about pt.