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Code management
- 1. 1 Code Blue Cardiac Nursing Care Qaisar Iqbal Shifa College of Nursing
- 2. 2
- 3. Objectives • By the end of presentation students will be able to – State the purpose to using code language – Describe the mechanism of cardiac arrest – Explain the importance of primary and secondary CABD survey – Explain the treatment hierarchy of code blue – Describe post cardiac arrest care 3
- 4. 4 Cardiac Arrest • Mechanisms – Ventricular Fibrillation – Asystole – Pulseless Electrical Activity (PEA) – Pulseless Ventricular Tachycardia
- 6. 6 Asystole
- 9. Code Blue Team 9 Compressor Breather Recorder Medicine Administrator Team Leader Coordinator Runner Nursing Supervisor Security First Responder
- 10. 10 Primary CABD Survey • Focus: Basic CPR and Defibrillation – Check responsiveness – Activate emergency response system – Call for defibrillator Circulation Airway Breathing Defibrillation
- 11. 11
- 12. 12
- 13. 13
- 14. 14 Contributing factor • Hypoxia (CNS events) • Hypo/hyperkalemia • Hypo/hyperthermia • Hypo/hyperglycemia • Hypovolemia • Trauma • Tamponade • Thrombosis – (pulmonary/coronary) • Tablets (ODs, drugs, etc) • Tension pneumothorax
- 15. 15 ETT Drugs • L = Lidocaine • E = Epinephrine • A = Atropine • N = Narcan
- 16. 16 IV Push Drugs • P = Vasopressin • L = Lidocaine • A = Atropine • C = Amiodarone • E = Ephinephrine
- 17. 17 IV Drip Drugs • L = Lidocaine • E = Epinephrine • A = Amiodarone • D = Dopamine • S = Solutions (IV)
- 18. 18 Documentation during code blue
- 19. 19
- 20. 20 Post-resuscitation Care • Suppression of ventricular irritability – If VT or VF converted before lidocaine given, lidocaine bolus and drip – If lidocaine or bretylium worked, begin infusion – Suppress irritability before giving vasopressors
- 21. 21 Pearls of Successive Code Blue • Early identification of arrhythmia • Early response • Early CPR • Early defibrillation • Early advanced care
- 22. 22 • 20 mls IV push followed by resuscitative medications • Identifying and treating contributing factors • Effective team work
Hinweis der Redaktion
- The first steps in all emergency treatment are quickly assess responsiveness, activate the EMS system, assess the ABCs, and if indicated start CPR and hunt for VF with the AED. The Primary ABCD Survey of the ACLS Approach is an effective way to remember these steps. Some people in apparent cardiac arrest will respond to the initial actions: A, opening the airway; B, performing ventilations; and C, performing chest compressions. These steps can also identify victims of an obstructed airway, which must be cleared. For patients without a pulse, the Primary ABCD Survey makes no mention of IV access. This is intentional. Although medications provide a clinical benefit in cardiac resuscitation, medications remain a distant second in the Primary ABCD Survey.