Code Blue

Regina QuAppelle

26 Nov 201313:44

Summary

TLDRThe transcript depicts a critical medical emergency in a hospital setting. Nurse Tammy discovers Mr. Smith, a 37-year-old diabetic with pancreatitis, unresponsive and not breathing. A code blue is called, initiating a resuscitation effort led by Dr. Sellinger. The team performs CPR, defibrillation, and administers medications like epinephrine and amiodarone. After intubation and treatment for hypoglycemia, Mr. Smith's condition stabilizes, and he's prepared for ICU transfer. The team's coordinated response highlights the urgency and complexity of in-hospital resuscitations.

Takeaways

🚑 Mr. Smith, a 37-year-old diabetic with pancreatitis, was found unresponsive and not breathing, prompting a code blue emergency.
🏥 The medical team swiftly initiated CPR, defibrillation, and administered medications to stabilize Mr. Smith's condition.
💊 Epinephrine and amiodarone were given to address Mr. Smith's cardiac arrest, while D50 was administered for his low blood sugar.
🩺 The team performed intubation to secure Mr. Smith's airway and ensure proper oxygenation.
📝 Denise was responsible for scribing and documenting the events and actions taken during the code blue.
👨‍⚕️ Dr. Sellinger took charge as the code captain, directing the team's efforts and making critical decisions.
👨‍👩‍👧‍👦 Social work was involved to contact Mr. Smith's family, and the attending physician was informed of the emergency.
📈 The team monitored vital signs, including blood pressure and oxygen saturation, to assess Mr. Smith's response to interventions.
🏥 Post-resuscitation, arrangements were made to transfer Mr. Smith to the ICU for further care and monitoring.
🕒 Time management was crucial during the code blue, with the team documenting and verifying the timeline of events.
📊 A stat chest x-ray, ECG, and CCU bloodwork were ordered to further evaluate Mr. Smith's condition after the code.

Q & A

What is the initial emergency situation described in the script?
-The initial emergency situation is that Mr. Smith, a patient in room eight, is unresponsive, not breathing, and has no pulse, prompting a call for a 'code blue'.
What actions are taken by the medical team upon discovering Mr. Smith's condition?
-The medical team initiates CPR, calls for a code blue, prepares normal saline infusion, and starts bagging to assist with breathing.
Who takes on the role of the code captain during the emergency?
-Dr. Sellinger assumes the role of the code captain, leading the resuscitation efforts.
What is the first medication administered during the code blue?
-The first medication administered is epinephrine, given as a 1 milligram IV push.
What is the patient's medical history as mentioned in the script?
-Mr. Smith is a 37-year-old man admitted for pancreatitis, has diabetes with high blood sugar levels, and is febrile on the day of the emergency.
What additional treatments are requested by the code captain after the first defibrillation attempt?
-After the first defibrillation attempt, the code captain requests 500 mls of normal saline, 300 milligrams of amiodarone IV push, and a glucose check.
Why is intubation considered necessary during the emergency?
-Intubation is considered necessary because the medical team is having difficulty with bagging and needs to secure Mr. Smith's airway.
What is the patient's glucose level, and what action is taken as a result?
-The patient's glucose level is found to be 3.1, which is low. The team administers an amp of D50 (50% dextrose) IV push to address the hypoglycemia.
What is the final outcome of the code blue as described in the script?
-The code blue ends successfully with Mr. Smith achieving a normal sinus rhythm, a pulse, and a blood pressure of 88/40. The team prepares to transfer him to the ICU.
What are the post-code procedures mentioned in the script?
-Post-code procedures include continuing normal saline at a specified rate, ordering a stat chest x-ray, ECG, and CCU bloodwork, arranging a bed in the ICU, and documenting the code blue record.
How is the time management during the code blue handled, as per the script?
-Time management is handled by having a designated person, Denise, to keep track of time intervals and notify the team when two minutes have passed since the last intervention.

Outlines

00:00

🚑 Emergency Code Blue Activation

The video script begins with a nurse, Tammy, discovering that Mr. Smith, a 37-year-old patient with a history of pancreatitis, is unresponsive and not breathing. She calls for a code blue, initiating an emergency response. The medical team rushes to the scene, stopping Tammy's antibiotic infusion and starting normal saline. They prepare for CPR, with one team member grabbing a bagger for manual ventilation. The situation is tense as they work to resuscitate Mr. Smith, with the team leader, Dr. Sellinger, taking charge and directing the resuscitation efforts, including defibrillation and the administration of epinephrine. The team also discusses Mr. Smith's medical history, including his diabetes and recent fever, and a social worker is tasked with contacting his family.

05:01

🩺 Intensive Resuscitation Efforts

In the second paragraph, the medical team continues their resuscitation efforts on Mr. Smith. They reassess his condition after a defibrillation attempt and prepare to administer amiodarone and glucose due to a low glucose reading. The team faces challenges with bagging and decides to intubate the patient. They gather the necessary equipment for intubation and continue CPR while preparing for the procedure. The team also checks Mr. Smith's vitals, including his oxygen saturation, which is not immediately available, and they prepare to administer another dose of epinephrine. The paragraph highlights the team's coordination and the rapid decision-making necessary during a code blue situation.

10:03

🛑 Successful Resuscitation and Post-Code Procedures

The final paragraph describes the successful resuscitation of Mr. Smith, as the team detects a normal sinus rhythm and a pulse. They proceed to check his blood pressure and decide to continue with normal saline infusion. Post-resuscitation, the team orders a chest x-ray, ECG, and bloodwork, and arranges for Mr. Smith to be transferred to the ICU. The code blue is declared over, and the team documents the event, with each member verifying and signing the code blue record. The social worker and attending physician are updated, and the team prepares to transport Mr. Smith to the ICU. The paragraph concludes with the team leader printing a strip of Mr. Smith's sinus rhythm for the record, noting a 10-minute time discrepancy.

Mindmap

Keywords

💡Code Blue

A 'Code Blue' is a hospital emergency code that indicates a patient is experiencing a life-threatening event, such as cardiac or respiratory arrest, requiring immediate medical attention. In the script, the phrase 'Code Blue, room eight' is used to alert staff to initiate emergency response procedures for Mr. Smith, who is not breathing and has no pulse.

💡Pulse

A pulse is the rhythmic beating of the heart that can be felt in the arteries, typically measured at the wrist. It is a vital sign that reflects the heart's function. In the script, Tammy, the nurse, is unable to find a pulse, indicating that Mr. Smith is in a critical condition.

💡Defibrillation

Defibrillation is a medical procedure that delivers an electric shock to the heart to restore a normal heart rhythm in the case of life-threatening arrhythmias. In the script, the team uses a defibrillator at 150 joules to attempt to restore Mr. Smith's heart rhythm.

💡Epinephrine

Epinephrine, also known as adrenaline, is a medication and hormone that is used to treat life-threatening allergic reactions and cardiac arrest. In the script, epinephrine is administered intravenously to Mr. Smith to stimulate his heart and improve his blood circulation during the code.

💡Intubation

Intubation is the process of inserting a tube into the trachea to maintain an open airway or to facilitate mechanical ventilation. In the script, the medical team decides to intubate Mr. Smith when they have difficulty bagging, indicating the need for mechanical ventilation.

💡Glucose

Glucose is a simple sugar that is the primary source of energy for the body's cells. In the script, a glucometer is used to measure Mr. Smith's glucose level, which is found to be 3.1, indicating hypoglycemia, a condition that can cause loss of consciousness and requires immediate treatment with an amp of D50, a concentrated glucose solution.

💡Antibiotics

Antibiotics are medications used to treat bacterial infections. In the script, Mr. Smith is on antibiotics, suggesting that he has an infection that the medical team is managing alongside his current emergency.

💡Pancreatitis

Pancreatitis is an inflammation of the pancreas that can be caused by factors such as gallstones, excessive alcohol consumption, or high triglyceride levels. Mr. Smith is mentioned to have been admitted to the hospital with pancreatitis, which is the underlying condition that may have contributed to his current critical state.

💡Diabetic

A diabetic is a person with diabetes, a chronic condition characterized by high blood sugar levels. Mr. Smith is described as diabetic, which is relevant to his medical management and could be a factor in his current emergency.

💡Febrile

Febrile refers to having a fever, which is a common symptom of infection or other illnesses. In the script, Mr. Smith is noted to be febrile in the morning, suggesting that he may have an infection or another condition that is causing his body temperature to rise.

💡Vital Signs

Vital signs are a group of medical measurements that provide an overview of a person's health, including body temperature, pulse, respiration rate, and blood pressure. In the script, Mr. Smith's last vital signs are mentioned, which include his blood pressure, pulse, and respiration rate, all of which are abnormal and indicate a medical emergency.

Highlights

Nurse Tammy reports to Mr. Smith's room and discovers he's unresponsive, not breathing, and without a pulse.

A code blue is called in room eight, indicating a life-threatening emergency.

The medical team initiates CPR and prepares for advanced life support measures.

Antibiotics are stopped, and normal saline is infused to stabilize the patient.

The team uses a bag-valve mask for better oxygenation during CPR.

Dr. Sellinger assumes the role of code captain, leading the resuscitation efforts.

Defibrillation is performed at 150 joules due to the identified cardiac rhythm.

Epinephrine is administered to enhance heart function during the code.

A history of pancreatitis and current diabetic condition is provided for context.

Normal saline and amiodarone are administered to address the patient's condition.

Efforts are made to contact the patient's family and inform the attending physician.

The team prepares for intubation to secure the patient's airway.

A glucometer reading reveals critically low blood sugar levels.

Dextrose is administered to address the hypoglycemia.

The patient's rhythm converts to a normal sinus rhythm after multiple interventions.

A stat chest x-ray, ECG, and bloodwork are ordered to further assess the patient's condition.

The patient is successfully transferred to the ICU for further care.

The code blue is documented, and all team members are asked to verify and sign the record.