Code Blue

Presenter : KAMIL AKRAM

Post RN BSCN
Objectives
By the end of lecture learner will be able to
1. Define code blue
2. Discuss different type of codes in hospital
setting
3. Describe role of each responding RN during
a code blue
4. Identify the steps to take for an organized,
efficient and effective response to a
medical emergency.
Background

2002:
 A survey of hospitals' emergency codes illustrated the
lack of uniformity existing among hospitals and allied
healthcare organizations in Florida.

 Florida Society for Health Security and Safety

Professionals (FSHSS), representing over 100
hospitals and health care systems in Florida,
recommended a standardized Emergency Code system
for hospitals.
• 2003:
• A working group of healthcare security and safety
professionals selected and recommended code identifiers for
use in Florida hospitals and other healthcare organizations.

 RED - Fire  GREY - Violence/Security

 BLUE – Cardiac / Respiratory Alert
Arrest  WHITE - Hostage
 PINK – Infant / Child  YELLOW - Lockdown
Abduction  GREEN - Mass Casualty /
 BLACK - Bomb Disaster
 ORANGE - Hazmat /  BROWN - Severe Weather
Bioterrorism
While the main
colors were
constant, flexibility
was built into the
system for
individual hospital
needs.
The goal is to have
a common set of
base colors
allowing for
customization.
Code Black
Bomb Threat
The majority of
hospitals are using
Code Black as the
designation for a
bomb threat.
Code Green
Disaster Plan
Activation
Code Green was
selected because
green means go!
A disaster plan
needs to be
activated quickly
for effective
response.
Code Red
Fire
Code Red is a
national standard
recommended by
the Hospital Fire
Marshall’s
Association and its
membership.
Code Orange
Hazardous
Materials
There was
consensus for the
use of Code
Orange indicating
a hazardous
material incident.
Not just for the
activation of the
decontamination
team but other
incidents involving
hazardous
materials.
Code Blue
Medical
Emergency
A majority of
healthcare entities
are using Code Blue
for cardiac and/or
respiratory arrest.
Code Blue 13
Medical
Emergency
Code Blue 13 is
used in some
counties to denote
that the Code Blue
is for a pediatric
“code.”
Code Pink
Infant / Child
Abduction
Code Pink is also
used by many
organizations to
inform employees
regarding an
abduction attempt.
Code Pink
Infant / Child
Abduction
 Please consider adding
Code Pink with an age
to differentiate
between a infant and
pediatric patient.
 Example: Code Pink 2 – is
a two year old – this helps
staff adjust to looking for
a toddler vs. an infant
that may be concealed in
a bag or suitcase.
Code Pink
Infant / Child
Abduction
The National Center
for Missing and
Exploited Children
has issued Volume 9
of the Healthcare
Guidelines.
This is the first
update since 2005.
Code Silver
Active Shooter
Code Silver is a
new code added as
hospitals are
starting to
experience more of
these events on
their campuses.
Code Silver
This code is similar to the Silver Alert for
a missing elderly individual in the
community.
Why was the same color code used?
Healthcare is a unique environment;
There’s a national consensus among hospital
codes;
It is intended to be used in hospitals primarily
to inform healthcare workers about a potential
situation – not the public.
Code White
Hostage Situation
Code Blue
How to respond??????????????/
How will you Repond?
Cardiopulmonary Resuscitation (CPR)
Definition
Cardiopulmonary Resuscitation (CPR)
is an emergency procedure performed in an
effort to manually preserve intact brain
function/provide adequate blood circulation
until further measures are taken to restore
spontaneous blood circulation and breathing
in a person in cardiac arrest.
Code Blue

Definition

is generally used to indicate a patient

requiring resuscitation or otherwise in need
of immediate medical attention, most often as
a result of a respiratory or cardiac arrest.
Code Blue Team

is adult/pediatric focused group of multi-

disciplined clinicians, nurses and paramedical staff
with pre-designated responsibility to provide initial
emergency care and/or CPR when necessary.
Code Blue Team Members:
.Physician
Registered Nurse
.Nurse Supervisor
.Respiratory Therapist
Code Blue Policies

All patients who has an identified need for CPR shall be treated
fairly
All CPR efforts and procedures
There is an active Code Blue Team with clearly defined
members, roles and responsibilities
The code blue team schedule should be placed in all departments
All members of Code Blue team must hold a current and valid
BLS and ACLS certificate and PALS ,as needed.
All equipment shall be available and functional at all times to
manage clinical emergencies requiring CPR. The equipment is
checked as per hospital protocol.
 Basic Responsibilities of the Nurses in CPR
 On discovering the arrest, call out the name of the patient loudly and
clearly and shake his/her shoulder. Make sure the patient is not merely in
deep sleep.
 After establishing true unresponsiveness .
 Call for help!
 Alert second rescuer
 to call code and bring the crash cart.
 Call ___ .State Code
 Blue (Adult/Pediatric), Department, floor and room number
Announcement should be done three times.
 Initiate prompt effective Basic Life Support. DO NOT WAIT for
assistance. Place patient on supine position and begin CPR.
 What to prepare in any critical state ?
 Oxygen
 IV access
 Monitor
Number of Nurses who must participate in a code?
A. Critical Units a minimum of three (3)nurses and the
charge nurse/nurse supervisor must be present in a code.

The role of each nurse represents:

 Airway Nurse
 Medication
 Documentation

Number of Nurses who must participate in a code?

B. In the WARD, during the code a minimum of four (4)
nurses and the charge nurse/nurse supervisor must be
present. The roles of each nurse represents:
 Airway Nurse
 Medication
 Documentation
 Circulating
This is usually the Charge Nurse /Nurse
supervisor. For accurate documentation
she/he should not participate in the code.
She/he must observe and document the
actions carried out by the nurse.
Supervises the overall management of an
arrest situation.
Know the code blue team members.
Ensures crash cart arrival (if not yet available)
and dispatches for any other supplies urgently
required.
Ensures all observations are taken and recorded.
Coordinate all nursing activities and ensures that
all designated code blue nursing activities are
being performed as specified
Maintains crowd control-dismisses those not
required for other duties and also unwanted
guests
Record code events in chronological order on the
special form provided
Can give therapeutic feedback post code
debriefing to the participants of the code
Reference
Florida Society for Healthcare Risk Management and
Patient Safety
International Association for Healthcare Security and Safety
Florida Healthcare Engineering Association
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