Running a code

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During a code blue in the OR, what task does the circulator do?

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Specializes in Operating Room (and a bit of med/surg).

Depends on the situation... but usually the circulator takes on the role of delegation. Scrub obviously stays scrubbed, then additional people who come in are directed what to do by the circulator. (eg- one assists anesthetist, one works with scrub nurse, one does computer for labs and ordering blood, etc.) Fortunately we have very few true code blue situations. (knock on wood!)

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How odd that this question has been asked because just recently I was involved with a code in the OR I work in...at this facility, perioperative RNs DO NOT have to be ACLS trained/certified, but I am. I think that the ACLS knowledge I have helped the code run smoothly...

I am also working on a research paper about codes in the OR. I'm curious, if anyone is willing to give up some info: as perioperative RNs in your facility, does the policy require BLS or ACLS? Also, do you participate in mock codes in the OR to keep skills up?

Any info/help would really be appreciated...there is not a lot of nursing research/literature on the subject!

:bow:

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In my facility, ACLS required for RNFA's only. No code drills.

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If the management team offered you a chance to sit on a committee of sorts that deals with codes in the OR, is that something that you would be interested in?

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Specializes in Operating Room (and a bit of med/surg).

No ACLS required. Our college requires us to have BLS certification. In our code situations, the anesthetists run the show. On shift, our PACU nurses come to assist (and of course they have ACLS). There are a few people who are ACLS, though mostly from previous positions (emerg nurses) but they have kept up their qualifications.

We don't really do mock codes. I think we did one once as an inservice last year. I think it would be good to run mock codes though, and then have a debriefing time afterwards. It would be much more useful than the stuff we often do.

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Specializes in surgical, emergency.

I suspect that it's different for different places, hospital vs surg. center, etc.,,,,also time of day!

In our OR the circulators are BLS/ACLS certified, we also have our TNCC, some have PALS as well.

Knock on big time wood.....it's been a while since we had a true code in the OR, most of the time we get them off the table, or maybe some drug intervention is required.

Our circulators, depending on the situation tend to take over drugs/defibrillator or scribe. Anes. docs run the code, and the rest help out as needed.

Again, depending on the situation, scrub techs may drop out and do compressions, etc.

We've not done mock codes, not in rest of my hospital either. Not saying it's a bad idea, we just don't do it.

I sort of hate to talk about it....sort of like your most feared procedure or recurring nightmare pt...you talk about it and it happens. If we have a code tomorrow,,,I'm coming back to get you!! :chuckle

Just kidding.....

Mike

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Thanks for the feedback, I appreciate it! I'm wondering if perhaps I should include simulated malignant hyperthermia crisis...lightbulb.png

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Specializes in ICU, Transport, Instructor, Educator.

Humblecirculator, I was wondering if you ever got information about Codes within the OR. We are looking at using the Code team or how to integrate them. I have not seem much research on the subject. Any help would be great

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Humblecirculator, I was wondering if you ever got information about Codes within the OR. We are looking at using the Code team or how to integrate them. I have not seem much research on the subject. Any help would be great

Well, I didn't get very far at my facility about codes in our OR ... right now im in Jersey for a seminar, but when I get back home, I will email you the paper if you like ... its been a while since I've touched that subject, but if I recall correctly, the paper was very good (just a lil biased!!)

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Specializes in OR, peds, PALS, ICU, camp, school.

At our facility, Circs were in charge of the code record.

Only the nurse who was permanently assigned to holding needed ACLS. I happened to have PALS and ACLS from my other job. I think it helped but it also caused some issues when I wouldn't "get out of the way" of people who thought they knew more than me, LOL. A PACU RN usually came to a code but mostly is was the extra anesthesia providers who ran it all. As well they should.

Mock codes are a fab idea (we never did but should have.) MH runs should be part of it.

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Specializes in PeriOperative.

In my facility:

Anesthesia announces the code.

The circulator pages the charge nurse, and all anesthesia attending physicians.

The scrub moves the mayo and back table out of the way and maintains sterility.

Anesthesia runs the code, pushes all meds, and delegates.

The surgeons give compressions.

The circulator might have to leave the room to get someone/something (ie the defibrillator) or operate the defibrillator.

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