Code blue training

(Based on AHA 2015 guidelines)

1. Relative calls
2. First responder confirms – shake & shout
-- Check carotid for 10 seconds
_ Call for help
3. First start chest compressions after
 Making bed straight
 Lowering the side bed rails
 Puling the bed away from the wall
 Start chest compressions from wall side , so that others can
work from free area side
4. Second responder announces the code blue and bring the defibrillator by hand and
others bring crash cart
On the site of arrest:
 First responder doing chest compression
 Attach defibrillator , if it comes first (ECG leads for rhythm analysis)
5. Team leader introduces himself/herself (I am Dr. ___________ I am the team leader) and
orders
 Attach defibrillator (if not already attached )
 Analyses the rhythm
 Patient in VT / Vf , give 360 DC shock
6. Other person gives the shock, follow protocol
 Select energy
 Recharge, apply paddles
 Confirm safety (I clear, you clear, all clear)
 Give shock ( say, “shock given”)
7. Team leader orders
 you give breaths by Ambu bag , attach O2
 you record the event
 you start IV line & draw blood sample
 Give Inj. Adrenaline 1 mg iv, flush with 10 ml NS & raise the arm
8. Staff confirms
 1 mg Inj. Adrenaline given
 Flushed with 10 ml NS
 Arm raised
9. Chest compressions & ventilation persons rotate every two minutes
10. Event recorder fills the code blue form
 Speaks out loudly every 2 minutes “ 2 minute over”
11. Team leader analyses rhythm every 2 minutes
 Repeat Inj Adrenline , 1 mg iv every 4 minutes
 Advices shock for VT/Vf
 Inj Amiodarone 300 ml IV & flush after 3 shocks , if patient still in Vf
 No shock for Asystole. Continue CPR and Adrenalin 1 mg every 4 minutes
12. Team leader reviews reversible causes
 Patient is not Hypothermic
 What is RBS? –No Hypo/Hyperglycemia
 How much is Potassium –No Hypo/Hyperkalemia
 No H/O trauma /blood loss –No Hypovolemia
 Ventilation is ok –No Hypoxia
 No H/O consuming poison -Toxins
13. Team leader consider advanced airway – endotracheal intubation
 Bring laryngoscope
 7.5 mm endotracheal tube
 Do intubation
14. Return of spontaneous circulation (ROSC)
 Pulse present
 BP
 Capnography (EtCO2 40 )