What does CNA do during code blue?

ctmed · Jul 31, 2012

Y'all need towels?

But seriously, we are not the New Orleans Saints but the ones that clean the Superdome. Most facilities will have a team of the strongest RNs/LPNs and respiratory who will show. In a nursing home, it will be a few LPNs until the EMT-B's and paramedics arrive.

CPR is only for us a last resort and by state guidelines.

We also seldom have access to if patients are DNR or full code. But, this depends on facility.

mstearns09 · Jul 31, 2012

Y'all need towels?
But seriously, we are not the New Orleans Saints but the ones that clean the Superdome. Most facilities will have a team of the strongest RNs/LPNs and respiratory who will show. In a nursing home, it will be a few LPNs until the EMT-B's and paramedics arrive.
CPR is only for us a last resort and by state guidelines.
We also seldom have access to if patients are DNR or full code. But, this depends on facility.

Interesting. All of our residents' name plaques and beds are marked with stickers to designate them as DNR or full code. The average person walking into our facility would never know what those stickers mean unless they worked there, though.

jjones435 · Jul 31, 2012

CNAs should be gofers, if there are enough people responding to the code, then they can use their time wisely and answer call bells.

Benedina · Jul 31, 2012

Ask your own facility's trainers and, especially, unit supervisors. I'm a CNA on a medical unit where we do our own shift reports, CNA to CNA. We pass on DNR/full code information in every shift report, keep our BLS certs up to date, and have regular unit education on how to initiate codes precisely because we are expected to respond immediately and correctly in code situations.

Patient on the bathroom floor: if I forget which patient of mine is DNR, I would look for the purple DNR band on the wrist. In its absence I am required to call a code and begin compressions. Help will be there in a minute, and, yes, I would expect RNs, docs, CCOR, etc., to elbow me out of the way soon.

At which time I'll either be a gofer for the code team or go back to the floor and take care of the other patients. Another aide on our floor is EMT trained, and she is more likely to stay for the entire code. She is fast, strong, knowledgable, experienced, and several RNs have commented that they hope she's there when we have a code.

Dina

Sherpie · Jul 31, 2012

I am a CNA in a long term care facility. I have performed CPR 3 times in the 8 years that I have worked there. At our facility when a code blue is called everyone is expected to respond. Whoever is nearest the crash cart grabs it on their way to the code. Each time I have been there for a code, the CNA's have been performing CPR. The nurses have been calling the ambulance, and getting paperwork together. The paramedics usually have us continue CPR after they arrive as well. I think the ones most comfortable with jumping in and helping are the ones that do, regardless of whether they are a CNA or a nurse. At one code I responded to, the nurse that should have been there freaked out and hid. There are also a lot of CNA's that I work with that don't handle the codes very well.

BrittaLeigh313 · Jul 31, 2012

Hey, hon!

Congratulations on the hire! You'll get some invaluable experience as a CNA. Just never forget when you're a nurse, that you were once a CNA.

I'm a CNAII in the emergency department of a Level 1 trauma center and teaching hospital that's in the national top 10 (not bragging, just stating). In my previous job as a float pool CNAI in a very small community hospital, I was an onlooker/runner.

Now, in my ED, we NAs are what I call the CPR brigade. The running joke is "If you're not breaking ribs, you're not doing it right!" We have a trauma/resuscitation area so all our equipment, the AED, and the code drugs are at hand. But anywhere else, grab the crash cart and yell for people to get out of the way. We do the chest compressions and when it's July and we have new students/interns/residents we instruct them on how to do properly do compressions on an actual person. (I love hearing the doctors tell noobs, "These girls know what they're doing; listen to them.") Things to remember (on adults):

*The longer the code, the more distended and and air-filled the abdomen gets, the harder the compressions get.

*Screw the "thirty compressions to one breath" in a hospital code. Just keep going. Someone else can worry about the lungs.

*The tempo of CPR is (not even joking here) "Ah-ah-ah-ah stayin' alive, stayin' alive."

You'll never feel prouder than when you have your hands over that heart, the doctor orders you to hold CPR and has everyone do a pulse check, and you hear the words, "We have a pulse." Good luck, hon. I hope this helps. Remember the Bee Gees! "Ah-ah-ah-ah...." LOL!

BrittaLeigh313

laurie5256 · Jul 31, 2012

where i work, anyone can call for a code if they find a non responsive patient, as every minute counts and the time it takes a cna to find a nurse to call the code could mean life or death. mostly, one cna runs for things as needed, and the others continue their regular job while it's going on.

Ybur514 · Jul 31, 2012

Hey, hon!
Congratulations on the hire! You'll get some invaluable experience as a CNA. Just never forget when you're a nurse, that you were once a CNA.
I'm a CNAII in the emergency department of a Level 1 trauma center and teaching hospital that's in the national top 10 (not bragging, just stating). In my previous job as a float pool CNAI in a very small community hospital, I was an onlooker/runner.
Now, in my ED, we NAs are what I call the CPR brigade. The running joke is "If you're not breaking ribs, you're not doing it right!" We have a trauma/resuscitation area so all our equipment, the AED, and the code drugs are at hand. But anywhere else, grab the crash cart and yell for people to get out of the way. We do the chest compressions and when it's July and we have new students/interns/residents we instruct them on how to do properly do compressions on an actual person. (I love hearing the doctors tell noobs, "These girls know what they're doing; listen to them.") Things to remember (on adults):
*The longer the code, the more distended and and air-filled the abdomen gets, the harder the compressions get.
*Screw the "thirty compressions to one breath" in a hospital code. Just keep going. Someone else can worry about the lungs.
*The tempo of CPR is (not even joking here) "Ah-ah-ah-ah stayin' alive, stayin' alive."
You'll never feel prouder than when you have your hands over that heart, the doctor orders you to hold CPR and has everyone do a pulse check, and you hear the words, "We have a pulse." Good luck, hon. I hope this helps. Remember the Bee Gees! "Ah-ah-ah-ah...." LOL!
BrittaLeigh313

Hi Britta,

Thank u so much that helps me alot,lots of info..lol dats funny ok I will remember that bee-gees ah-ah-ah-ah and just sing it on my mind but hopefully when I encounter my very 1st patient who needs cpr I will do it right and accurate.:) so in the hospital its 30:1? instead of 30:2?,.now how cud I do the rescue breath is there always a cpr mask on the patients bedside table?..thank u so much! And oh dnt wori someday when I bcome nurse I'l always respect cnas:))

tigerlogic · Jul 31, 2012

Ask your manager.

At my hospital everyone who has patient contact-- including the housekeeping and dietary -- has CPR training and is expected to call a code and start compressions if they find someone unresponsive. period. (This would be different in LTC) Also, after many/most (?) major surgeries, DNR automatically changes to Full Code at my hosptial. If you don't know their code status start the code -- it can be stopped later. We also have a RRT (rapid response team) that's kind of a pre code blue team that gets called sometimes.

For my hospital, CNAs can clear extra things out of the room, be a runner, and answer other call lights/keep the rest of the unit calm after the code team has arrived.

But really, clarify this with the facility where you're working.

Ybur514 · Jul 31, 2012

Ask your own facility's trainers and, especially, unit supervisors. I'm a CNA on a medical unit where we do our own shift reports, CNA to CNA. We pass on DNR/full code information in every shift report, keep our BLS certs up to date, and have regular unit education on how to initiate codes precisely because we are expected to respond immediately and correctly in code situations.
Patient on the bathroom floor: if I forget which patient of mine is DNR, I would look for the purple DNR band on the wrist. In its absence I am required to call a code and begin compressions. Help will be there in a minute, and, yes, I would expect RNs, docs, CCOR, etc., to elbow me out of the way soon.
At which time I'll either be a gofer for the code team or go back to the floor and take care of the other patients. Another aide on our floor is EMT trained, and she is more likely to stay for the entire code. She is fast, strong, knowledgable, experienced, and several RNs have commented that they hope she's there when we have a code.
Dina

Hi Dina,

Thank u,yes my supervisor told me I can call a code too and start cpr while waiting for the team. Im gonna hve an orientation nxt week so hopefully they gonna show us proper way of calling a code blue. That code blue thing just making me so nervous..lol :))

Ybur514 · Jul 31, 2012

Thank u all guyz for all the helpful info's I will remember that. Luv this site...

classicdame, MSN, EdD · Jul 31, 2012

Our CNA's are certified in AHA CPR. They can "call" a code, but that does not mean the responding team will agree with them. They can do compressions for sure. With CPR knowledge they can be an asset to the team