1. CODE BLUE GUIDELINES

2. Assess Responsiveness of Client If unresponsive CALL FOR HELP CALL Facility Emergency Number Call for the AED

3. Airway Assessment *HEAD TILT-CHIN LIFT or JAW THRUST Watch for the chest to rise and fall Listen for air exchange Feel air move through the mouth NO BREATHING GIVE (2) BREATHS

4. Assess Circulation *CHECK CAROTID 10 SECONDS FOR ADULTS *CHECK BRACHIAL FOR INFANTS IF NO PULSE START COMPRESSIONS WITH RATIO OF (2) Breaths to (30) Compressions

5. Get “Code Cart” and Required Emergency Equipment Code Cart should have the following equipment on top: Monitor/Defibrillator (charged) Ambu Bag Suction Resuscitation Record Electrodes

6. Attach Monitor Leads to Client RA=right arm (white)“Smoke over RL=right leg (green) fire” LA=left arm (black)(black over LL=left leg (red) red)

7. ECG Analysis

8. “PLACE” monitor “LEADS” and “LEAN” monitor toward physician. This will help you remember DRUG therapy given by a variety of ROUTES.

9. “LEAN” ETT Drugs  L = Lidocaine  E = Epinephrine  A = Atropine  N = Narcan  Lidocaine for ventricular rhythms (reduce ventricular irritability)  Epinephrine improves cardiac function (increases vasoconstriction/ >BP & increases heart rate)  Atropine stimulates SA Node to increase heart rate  Narcan is antidote for Opioids

10. “PLACE” IV Push Drugs  P = Pitressin (Vasopressin)  L = Lidocaine  A = Atropine  C = Cordarone (Amiodarone)  E = Ephinephrine  Pitressin for vasoconstriction  Lidocaine for ventricular rhythms (reduces ventricular irritability)  Atropine stimulates the SA Node to increase heart rate  Cordarone for ventricular rhythms (decrease intraventricular conduction)  Epinephrine improve cardiac function (increases vaso- constriction & increases heart rate)

11. “LEADS” IV Drip Drugs  L = Lidocaine  E = Epinephrine  A = Amiodarone (Cordarone)  D = Dopamine  S = Solutions (IV)  Lidocaine for ventricular rhythms (reduces ventricular irritability)  Epinephrine to improve cardiac function (increases vaso- constriction & increases heart rate)  Amiodarone (Cordarone) for ventricular rhythms (decreases intraventricular conduction)  Dopamine has various effects at various rates (dilates renal artery, improves cardiac function, vasoconstriction/ >BP)  Solutions (IV) based of diagnosis

12. References:  American Heart Association 2005 Guidelines  Handbook of Critical Care