SCRIPT: CARDIAC ARREST RESPONSE
Characters:
Nurse 1 (Primary Rescuer)
Nurse 2 (Assistant Nurse)
Paramedic
CODE BLUE Team Leader (Physician)
Respiratory Therapist (RT)
Pharmacist (on-call)
Recorder Nurse (Documenter)
Scene: Emergency Department Resuscitation Bay
(Paramedics wheel in Mr. XYZ on a stretcher)
Paramedic:
Patient is a 58-year-old male, collapsed at work. Found unresponsive and not breathing. No
pulse during transport. We started chest compressions en route and administered oxygen via
bag valve mask.
Nurse 1:
Thank you. Let’s get him transferred to the stretcher here. Nurse 2, please prepare the
cardiac board and AED immediately.
Nurse 2:
On it. Cardiac board and AED are ready.
Nurse 1: (to patient)
Mr. Rivera, can you hear me? Are you okay? (shakes shoulders gently)
(No response)
Nurse 1:
No response. I’m going to check for breathing now. (looks, listens, and feels for breath for 10
seconds)
Nurse 1:
No breathing detected. Nurse 2, call CODE BLUE and notify the on-call physician
immediately.
Nurse 2: (on phone)
CODE BLUE in resuscitation bay. Adult cardiac arrest. Physician requested.
Nurse 1:
I’m checking for carotid pulse. (feels carotid artery) No pulse. Starting chest compressions
now.
(Nurse 1 begins compressions)
Nurse 1:
Compressions at rate over 100 per minute, depth at least 2 inches. Elbows locked, arms
straight. Nurse 2, prepare bag valve mask with oxygen.
Nurse 2:
Oxygen connected and ready. Bag valve mask assembled.
(After 30 compressions)
Nurse 1:
Opening airway with head tilt and chin lift. Giving two rescue breaths. Watch for chest rise.
(Chest rises)
Nurse 1:
Good chest rise. Resuming compressions.
(Nurse 3 arrives with AED)
Nurse 3:
AED is ready. Placing pads now.
Nurse 1:
Pads placed on apex and sternum. Everyone clear for rhythm analysis.
Nurse 3:
Analyzing rhythm. Shock advised.
Nurse 1:
I am clear, you are clear, everyone clear! (presses shock button) Shock delivered. Resuming
compressions immediately.
(CODE BLUE team arrives: Physician, Respiratory Therapist, Pharmacist, Recorder Nurse)
Team Leader (Physician):
Status report?
Nurse 1:
58-year-old male, unresponsive and apneic on arrival. No pulse. CPR started immediately.
One shock delivered. Continuing 30:2 cycles.
Team Leader:
Good. Continue CPR. RT, prepare for advanced airway management.
Respiratory Therapist:
Ready to assist with intubation.
Pharmacist:
Medications are on standby. Please advise when ready.
Team Leader:
Prepare to administer epinephrine after the next two CPR cycles.
Recorder Nurse:
I will document all times and interventions.
(After two more cycles)
Team Leader:
Stop compressions briefly. Check pulse.
Nurse 1:
No pulse detected. Resuming compressions.
Team Leader:
Administer 1 mg epinephrine IV now.
Nurse 2:
Epinephrine administered.
Team Leader:
Prepare for second shock if advised.
(AED advises shock again)
Nurse 3:
Shock advised. Everyone clear!
Nurse 1:
Clear! (delivers shock) Resume compressions.
(After several cycles)
Nurse 1:
Checking pulse. Pulse present. No spontaneous breathing.
Team Leader:
Provide rescue breaths every 5 seconds. Monitor closely.
Respiratory Therapist:
Intubation completed. Ventilator connected.
Team Leader:
Excellent. Monitor oxygen saturation and blood pressure.
Pharmacist:
Prepare amiodarone if rhythm deteriorates.
Team Leader:
Prepare for post-resuscitation care. Place patient in recovery position if no neck injury.
Nurse 1:
Recovery position ready. Monitoring breathing and pulse continuously.
Team Leader:
Good work, team. Nurse 2, prepare for transfer to ICU once stabilized.
Nurse 2:
Transfer preparations underway.
Recorder Nurse:
All interventions and times documented.
Post-Resuscitation Handoff
Team Leader:
Nurse 1, please provide a concise handover to the ICU team.
Nurse 1:
Mr. XYZ, 58 years old, presented with cardiac arrest. CPR initiated immediately with one
shock delivered pre-arrival and two shocks in ED. Epinephrine administered. Return of
spontaneous circulation achieved with pulse but no spontaneous breathing initially.
Intubated and ventilated. Currently stable, transferred for critical care.
ICU Nurse:
Thank you. We will continue monitoring and supportive care.