CODE BLUE
CARDIAC ARREST MANAGEMENT GUIDE
PRESENTED BY: dr. Ferry
Wardhana
TERMINOLOGY 2
Cardiopulmonary Arrest : udden stop in
effective blood flow due to the failure of
the heart to contract effectively.
Symptoms include loss of consciousness
and abnormal or absent breathing. Some
people may have chest pain, shortness of
breath, or nausea before this occurs.
Code Blue : a system design to react
against the event of cardiopulmonary
arrest
Code Blue Response Team : a team
consist of trained medical personels
tasked with aiding patient in critical
conditon
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INERTIAL FORCE
3
Three-axis coordinate system for describing direction of acceleration and inertial
forces acting on a human
Team Members Educational
Certification Man Power
Background
Consultant Physician Anesthesiologist/ICU Consultant ACLS, GELS (PPGD) 1
Doctor (Team Leader)S1 Primary Physician ACLS, GELS (PPGD) 6
Nurse S1/D3 Nurse BLS, BCLS
9
Man power Distribution :
1. Anesthesiologist/ICU Consultant as code blue team consultant
2. Responses team divided into 3 team (Team A, B1, B2)
Each Team Consist of
1 standby Doctor
2 standby nurses
1 in charge patrol
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Team Consultant 4
Anesthesiologist/ICU Consultant
Responsible to coordinate the whole team
Collaborate with training department to
held a regular emergency training for the
team
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1st person in the scene 5
First person who meets the patient/client (Ward
Nurse)
Secure the perimeter to ensure an enough
space around the patient
Check patients response with calling their
name or gentle tap to the shoulder
Call for help (help! Code blue!)
Put the patient in supine position on flat
surface
Check carotid pulse for vital sign
CPR (30:2) if no pulse until help comes
Clear the airway + Head tilt and chin lift
Check breathing, if there is no breathing,
assist breathing with BVM (no mouth to
mouth!!)
Hand over to
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2nd person in the scene 6
Second person who arrives in the scene (Ward
Nurse)
Ask for help by pushing the call button for
code blue team
Take the nearest emergency trolley,
portable suction and oxygen supply to the
scene
Put on the oropharyngeal airway
Connect the BVM to oxygen supply and set
to 10L/M
Provide ventilation with BVM
Ensure suction function
Prepared the intubation equipment and
become an assistent
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3rd, 4th, 5th person in the 7
scene
Third, fourth, and fifth person who arrives in the
scene (code blue team)
Take and bring emergency kit, and portable
defibrillator for non-clinic scene
Take over, ensure every procedure done
correctly like CPR, airway management,
documentation and questioning the 1st
person for the initial event
Prepared the defibrillator and put on the
pads (with jelly) on the patients chest
Check and make an IV line access and
preparing fluid replacement normal saline or
colloid
Prepare emergency drugs to be use as
indicated by the doctor
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Doctor 8
Standby doctor who arrives at the scene of
code blue
Take away as a leader
Check the patients condition and
hand over from the 1st person and the
team
Maintain ABC, Defibrilation and
Intubation
Instruct for emergency medication
according to ACLS flow chart
Report and discuss the patients
condition with patients attending
physician (DPJP)
Take a decision wether rescucitation
should be stopped or continued
Record the Slides
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Other Staffs 9
Other staffs or nurses
Clean the area from the equipment
and furniture
Calm the other patient or visitor
around code blue vicinity
Leave the are if not part of the code
blue team
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Ward Head/Rooms Person in 10
Charge
Ensure the medical record is recorded
correctly
Ensure the documentation form (code blue
form) filled out correctly
Filled out the ICU transfer form and
prepare the patient to be transferred to
the ICU
Ensure and delegate the condition, stock
and sanitary of emergency trolley post
code blue event
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Code Blue Activaton Flow chart Post CPR patient Disposition
Medical Emergency CPR 13
Nurse or staff on
scene Failed Succes
Push code blue Applying BLS or
botten or activate get emergency
PABX trolley Morgue
Arrive on the scene
(bringing emergency
kit, and portable
defibrillator)
Visitor/staff outpatient inpatient
yes no
System automatically send
massage to code blue team Ambulance/stretcher Transfer to ICU
yes no
nurse/staff System Stabilization in ER
caller dial automatically send
code blue massage to doctor
button
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