KW Code Blue Review

Exceptionally well done without prior dry run…a testimony as to the strength of this team!

Observer

Safety First

  1. Full PPE donned
  2. N95 required
  3. Spotter assesses PPE
  4. Only then team member can enter room

CRM – 8 Person Team

  1. 3 Nurses in roomFULL PPE
    1. 2 who rotate for compressions
    2. 1 to push meds (as masks become fogged over during CPR and RN cannot see to push meds)
  2. 1 Respiratory Therapist in roomFULL PPE
  3. 1 Doc in roomFULL PPE
  4. 1 team member in anteroomFULL PPE
    1. code team interface between room and hall
    2. who is communicating needs of code team
    3. handing crash cart meds to code team
  5. 1 team member just outside anteroomDroplet PPE
    1. spotter for donning/doffing of code team
    2. communicating with anteroom team member
    3. supplying/accessing crash cart meds
    4. delegating tasks outside room
    5. pushing meds/fluids through pumps outside room
  6. 1 team member at windowRegular PPE
    1. charting events
    2. timing events
  7. 1 team member who is runner – Regular PPE
    1. for the team member working pumps/code cart
    2. may need to bring over other supplies/meds
    3. procedure cart, infusions/analgesia/narcotics

Equipment and Meds

  1. In the room
    1. Zoll removed from cart and taken into room
    2. white board and marker
  2. In the anteroom
    1. 1 epinephrine AT ALL TIMES
    2. 1 atropine AT ALL TIMES
  3. In the hall
    1. crash cart
    2. med cart
    3. bonnets available on crash cart
    4. S/M/L  gloves available on crash cart
    5. face shields to be available on crash cart
    6. patient pumps

Communication

  1. Closed loop communication only.
    1. Within code team
    2. Code team to anteroom
    3. Anteroom to Just Outside Anteroom
  2. Team member at window
    1. Holds up a  2 min sign
    2. Knocks on window.
  3. Phone not clear enough during code

To Be Done

  1. need to create an expanded ICU code blue team
  2. laminated chart on crash cart that reminds code team of members roles/responsibilities
  3. place SML gloves on crash cart
  4. bonnets and face shields on crash cart
  5. 1 Epi/ 1 atropine in anterooms or outside
  6. 1 white board marker in patient room
  7. MRI extension tubing on all covid +ve or suspected cases with pumps outside rooms
  8. laminated “2 min” signs on crash cart
  9. Sim training for ICU team members