The of Code Blue

Role Teams
Andy Wijaya
PERHIMPUNA
DOKTER AHLI EMERGENSI
N INDONESIA
 Code

Blue ???
Code Blue is a declaration of or a state of

medical emergency and call for medical

personnel and equipment to attempt to

resuscitate a patient especially when in

cardiac arrest or respiratory distress or

failure

UU RI No 44 tahun 2009 tentang Rumah
pasal 29 ayat : Pelayanan medis
sakit
>> Hospital Emergency Codes (Kode
1 kedaruratan
emergensi

rumah sakit) diperlukan diseluruh rumah

sakit

untuk memberikan informasi secara cepat

 Activatio

n
1. When the person is and has

Whenunresponsive
Code Blue no
2. visitor staff
applies ???
signs of life.
member requires medical
or
The staff believe that the
urgent attention
patient,
within 10-15 minutes.

(Code blue manual by Royal Brisbane & Womans Hospital Health Service

District )
 Medical Emergency Team Calling
Criteria
Acute Changes in : andVital
All Cardiac Sign Arrests and All Conditions Listed
Respiratory
Airway ThreatenedBelow
Breathing All respiratory arrests
Respiratory rate < 5

Respiratory rate > 36

Circulation All cardiac arrests
Heart rate < 40

Heart rate > 140

Neurology Sudden fall in
Systolic Blood level of< consciousness
Pressure 90
(fall in GCS of > 2 point)

Repeated or Prolonged seizure

Other Any patient who does not fit the criteria above
who you are
seriously worried about
To call the Medical Emergency Team Phone xxxx and tell the operator
where you are

(Code blue manual by Royal Brisbane & Womans Hospital Health Service
Structure and of CodeBlue Tea

Roles
Physician m

as the CBT leader

Apply ACLS
algorithms crowd
Ensure good
Unit/Ward RN control
scene and
Initiate BLS including application of the AED

Assists the code team as needed

Give information to leader about the

patient
Facilitates communication with family

Critical Care/Emergency

Function as team leader until the physician

RN
arrives

Manage and monitors defibrilator and rhythm

strips
ApplyManager
chest compression (CPR)
Airway
Administer

Provide basicmedication
and advanced airway
Bag Valve Mask

Documentation
management
ventilation: record

Manage theoxygen
High fow emergency trolley
Suctioning
Gerganof 2012; Code arrest/code blue management within CHN Facilities :

Carondelet intubation
Health

Network

Montgomery College Hospital Simulation Lab : Code Blue team : Roles and
 Tea Positionon Scen

m e
CP

( one or

two) IV Nurse

Change +
Documentati Providin
every
on g safe
2
defibrilati
minute
on
Copied from Montgomery College Hospital Simulation Lab : Code Blue team : Roles
 Team Communication

Effective communication is Critical

for team
Communication that everybod
working in crisis situation.

ensures y
what is going on,

wha needs
knows : to be

t done,
wha is already
REMEMBER : Communication is to
t done.
important

A message is only if it is both

communicated

Meant is not said

SENT
Saidand RECEIVED
is not heard

Heard is not
understood
Understood is not
done
 Step for

Communication
The leader should give an order or then

assignment
Closed loop communication
Team members confirm that the order or
confirm that the message was heard.
assignment
was heard
Example:
inform the leader when the task is
Team Leader : Give 1 mg
complete.
Epinepherine IV now IV Nurse : 1 mg
Epinepherine given IV at 9:05.

Clear messages

All messages should be delivered in a calm and

direct

No yelling or shouting.

Speak clearly.
Clear roles and
Every member ofshould
Team members the team should
question anknow
order
his/her role
responsibilities
if they are
and responsibilities.
unsure what was said.
To avoid inefficiencies, the team leader

should clearly
delegate tasks.
A team member should not accept

Knowing ones limitations
Every member of the team should know
his/her imitations and capabilities and the
team leader should be aware of them.
A new skill should not be attempted during
the arrest.
Knowledge sharing
A critical component of effective team
performance is
information sharing.
The team leader can ask for other

Constructive intervention

During a code, a team leader or member

may
need to intervene if an action is about to

occur at
an inappropriate

time.
The person recording the event may

Reevaluation and summarizing
An essential role of the team leader is
monitoring and reevaluation of the status of
the patient, interventions that have been done
and assessment findings.
Mutual Respect
The best teams are composed of members
who share a mutual respect for each other
and work together in a collegial, supportive
manner. All team members should leave
their egos
(Montgomery at 2011
college, the door.
: Code Blue team : roles and

function)
 Documentation

CODE BLUE RECORD is utilized

for events that

occur during the code.

The RN functioning as the recorder
during the code completes this form
and attaches any pertinent monitor
strips. The original code blue record
remains with the patient record and
a copy is sent to the site specific