2. 1 Code Team Members Roles and Responsibilities Jamileh Mokhtari nori, MSN, PhD candidate Nursing Faculty, Nursing Management Dept., Baqiyatallah Medical Sciences University.

3. Code Team is multidisciplinary team that responds to code calls. DEFINITION

4. 3 Purposes of Code Team n Notification and availability of Members n Avoid confusions and panic n Optimal care in minimal time limits

5. 4 Code Team Requirements Code Team Requirements n Basic Cardiac Life Support (BCLS) n Advance Cardiac Life Support (ACLS). n Pediatric Advance Life Support (PALS). n All Code team members and emergency nurses must be familiar with the code cart contents.

6. Code Team Members Roles and Responsibilities 1. Director of the Code 2. Primary nurse 3. Nurse 4. Nursing supervisor 5. Nurse or assistant 6. Anesthesiologist/ nurse anesthetist/emergency physician 7. Respiratory therapist 8. Code management pharmacist/technician 9. ECG technician 10. Chaplain 1. Director of the Code 2. Primary nurse 3. Nurse 4. Nursing supervisor 5. Nurse or assistant 6. Anesthesiologist/ nurse anesthetist/emergency physician 7. Respiratory therapist 8. Code management pharmacist/technician 9. ECG technician 10. Chaplain 5

7. * Director of the Code (usually a physician) Make diagnoses and treatment decisions * Director of the Code (usually a physician) Make diagnoses and treatment decisions 6

8. * Primary nurse n n Provide information to code director n n Contact attending physician n n Assist medications and procedures * Primary nurse n n Provide information to code director n n Contact attending physician n n Assist medications and procedures 7

9. * Nurse   Coordinate use of the crash cart   Prepare medications   Assemble equipment (intubation, suction)   Defibrillate * Nurse   Coordinate use of the crash cart   Prepare medications   Assemble equipment (intubation, suction)   Defibrillate 8

10. * Nursing supervisor n n Control the crowd n n Assist medications and procedures n n Ensure bed in Critical C.U. n n Assist transfer * Nursing supervisor n n Control the crowd n n Assist medications and procedures n n Ensure bed in Critical C.U. n n Assist transfer 9

11. * Nurse or assistant Record events * Nurse or assistant Record events 10

12. * Anesthesiologist/ nurse anesthetist/emergency physician   Intubate patient   Manage airway and oxygenation * Anesthesiologist/ nurse anesthetist/emergency physician   Intubate patient   Manage airway and oxygenation

13. * Respiratory therapist Set up respiratory equipment & Assist ventilation Draw ABGs * Respiratory therapist Set up respiratory equipment & Assist ventilation Draw ABGs 12

14. * Code management pharmacist/technician o o Assist medication administration o o Prepare IV infusions * Code management pharmacist/technician o o Assist medication administration o o Prepare IV infusions 13

15. * ECG technician Obtain 12-Lead ECG * ECG technician Obtain 12-Lead ECG 14

16. * Chaplain Support family * Chaplain Support family 15

17. Priorities during a code 1. Recognition of arrest 2. Arrival of resuscitation team, emergency cart, monitor- defibrillator, automatic external defibrillator 3. Rhythm diagnosis 4. Prompt defibrillation 5. Intubation 6. Venous Access 7. Drug administration 8. Assessment response to therapy 9. Drawing arterial and venous blood specimens 10. Documentation 11. Controlling or limiting crowd 12. Family notification 13. Transfer Critical C.U. 14. Critique 1. Recognition of arrest 2. Arrival of resuscitation team, emergency cart, monitor- defibrillator, automatic external defibrillator 3. Rhythm diagnosis 4. Prompt defibrillation 5. Intubation 6. Venous Access 7. Drug administration 8. Assessment response to therapy 9. Drawing arterial and venous blood specimens 10. Documentation 11. Controlling or limiting crowd 12. Family notification 13. Transfer Critical C.U. 14. Critique 16

18. 17

19. Crash Cart

20. Contents of a crash cart Main Items Specific Supplies Back Cardiac board Side Portable suction machine, bag- valve device & o2 tank Suction canister and tubing, face mask, o2 tubing Top Monitor-defibrillator with recorder, clipboard with code record and drug calculation reference sheets ECG Leads, electrodes, gel or pads; pacemaker

21. Contents of a crash cart Main Items Specific Supplies Airway supply drawer IV supply drawer Oral & nasal airways, ETTs, stylet, laryngoscope handle and curved and straight blades, Magil forceps, lubricating jelly, 5-ml syringes and tape IV catheters of various sizes, tape, syringes, needles and needleless adaptors, IV fluids (NS, Ringer’s lactate solution, and D5W), & IV tubing.

22. Contents of a crash cart Main Items Specific Supplies Medication drawer Miscellaneous supply drawer Procedure trays All IV push emergency medications in prefilled syringes if available, sterile water and NS for injection & IV infusion emergency medication. Sterile and nonsterile gloves, suction catheters, nasogastric tubes, chest tubes, blood pressure cuff, blood collection tubes, sutures, pacemaker magnet, extra ECG recording paper Cut-down, tracheostomy and central line insertion trays

23. خسته نباشيد 22