If you are working in a hospital or are a patient or a visitor you will see there is an immediate response to the words “CODE BLUE. ” To the observer it is apparent that there is a rush of hospital staff to the room or location of the emergency.
In a Code Blue adrenaline is sometimes part of the fuel for the chaos. When someone has recognized an acute clinical change in a patient. One that may be life threatening if care or support is not immediate. She or he has made a clinical judgement and assumes the responsibility for calling a code. Along with the staff and equipment is usually a cart that contains all the most probable medications that are ready for rapid access and administration as indicated.
To the person without a medical background you may see the patient as being short of breath or in apparent pain. On the other hand, maybe even unresponsive. To the medical staff, an assessment will show they may also have a faint pulse, clammy skin to touch, and a falling blood pressure reading or faint or irregular pulse. This person may or may not be bleeding and the pulse oximeter may show they are not getting enough oxygen with a poor respiratory status.
The pace of a code often is somewhat disjointed until the full assessment is determined. In spite of its hectic pace, each person involved takes on a particular role in the code. The main objective is to quickly stabilize a patient. An EKG is done and a monitor is placed on the patient to monitor the cardiac function of a patient. To have access to administer drugs that are indicated and to give IV fluids if needed. A nurse or doctor will insert an appropriate IV line, an access with a large lumen or a central line so that if the patient needs blood it will be available. At this time they can also draw blood to have it analyzed at the lab immediately for quick results. This will help evaluate the patient. Then to treat them appropriately.
Oxygen can be given to the patient during this time usually through a mask or a nasal cannula. According to what is appropriate to this patient’s situation. Measurements of the patient’s oxygen level can be done with a finger clip piece of equipment and as well with arterial blood work drawn. In some situations, it is appropriate to insert a catheter into the bladder to monitor urine output, renal function and to ascertain through a urinalysis that a patient does not have a urinary tract infection. If a patient is alert, verbal communications can confirm mental status with appropriate or inappropriate responses. Unresponsive patients can be evaluated with neurological checks.
During these activities. One doctor or nurse, depending on how staff arrives on the scene, will take the lead and direct staff to stay focused on the priorities. Another person will keep track of all that takes place by writing everything down on a form that helps keep a record of the code itself. An assessment of the patients chart helps to understand underlying conditions prior to the event. On the code record form is the staff involved, including the time of every intervention, medication given and the patient’s vital signs. A doctor is the chief coordinator of a code. The record is to learn more by assessing the code, its outcome and to recognize where improvements are needed.
Staff who are not involved in the code itself will be involved with the other support help needed. Contacting family, obtaining lab results, passing on information or supplies needed to code members. The staff may need to coordinate a transfer to Intensive care if the patient is to be transported for acute care monitoring. In some events even when the best of care is given during a code. The patient may pass away. The only comfort to the family and staff is that every effort had been made to save a life.
In conclusion, you might like to know that many lives are saved during this medically choreographed event. It is less then smooth, as each person becomes part of this event, and because each patient’s event is unique. The staff that is part of a code team becomes more proficient with experience; each code has the same ultimate objective. To stabilize a patient, and to save a life.
Some patients’ become aware after it is all over and asks the staff ” what are you doing here?”
Grateful relief and laughter of the exhausted code team usually follows that question.