MEWS- Modified Early Warning Score VA Emergency Response Early Response Team For inpatients with acute changes in BP, HR, SatO2, UOP, mental status Code Team members will get call on Code pager Team Members: MICU Resident, MICU RN, ICU, RT How to call an ERT Inpatient Nursing staff pages 32- 7273 & gives 3 digit bed number Documentation: Early Response Team Call Template- CPRS Patients with MEWS Scores >3, Charge nurse will call Med Team to assess patient – ERT will be call if team can’t be reached. MEWS- Modified Early Warning Score CODE Team All codes are call by dialing Code Operator @ 6911 Code Team members will get call on Code pager INPATIENT CODE TEAM RESPONSE Bedtower, Dialysis,, Cardiac Cath Lab, Cath Recovery, Chemo Clinic, Radiology, Bronchoscopy Suite, Sleep Lab, GI/ MDSU, MRI, Nuc Med Team members: MICU Resident &/or Fellow, MICU RN, SICU RN, Anesthesia, RT, Pharmacist ( day shift), Nursing Supervisor OUTPATIENT CODE TEAM RESPONSE Primary Care Clinics, Outpatient clinics, Lab, basement, waiting rooms, hallways, Canteen, Retail store, parking lot Team members: ED RN, ED Tech, RT transport patient to ED DOCUMENTATION 1. Code Recorder sheet- Becomes physician’s order sheet, must be signed by Code Leader post-Code . 2. CODE BLUE SUMMARY- CPRS TEMPLATE- Must be completed by the Code Leader in the patient’s CPRS Notes. SCORE 3 2 1 Temp <35 35-38.4 > 38.4 HR <40 40-44 45-50 51-100 101-110 111-129 >130 RR <7 8 9 10-14 15-20 21-29- >30 SBP <70 71-80 81-100 101-160 161-180 181-199 >200 LOC Un-resp Resp to pain Resp voice Alert Confused, restless, agitated MEWS scores are available on patient’s coversheet under clinical alerts and are tabulated @ 0800, 1600, 2200

CODE TEAM Roles & Responsibilities Primary RN Secondary RN RT Pharmacy Roll Call Operate defibrillator Check AED status Check rhythm Check timer Switch to manual - Secondary RN Check IV patency Check blood glucose/ draw labs Set up fluids Deliver medications Pharmacy Pull out med tray Draw up meds Make Medication recommendations to Leader RT Take over ventilating/ Oxygenating patient Monitor Sat O2 Place upper airway Coordinate 30:2 Assist with intubation - CODE LEADER Get Report Assess Patient Assess Situation Determine intervention Communicate Effectively Problem Solve Compressor 1 Take over compressions from 1st responders Check pad placement Check pulses with rhythm checks ANESTHESIA Place advanced airway Confirm ETT Placement Problem Solve with Leader Compressor 2 Check bed position Check hardboard Ensure compressor hears feedback from Zoll Recorder Record report from 1st responders Track time & announce Q2min Control Sound levels Recap interventions