“Code blue, Outpatient Hemodialysis Center”

“Code blue, Lobby North”

Over the announcement in the hospital, you can hear code blue being called but what is code blue?

As a new nurse or a nurse in a department that rarely experienced code blue, it can be a scary experience. The first step is understanding what code blue is.

Code blue is when cardiopulmonary arrest occurs in the hospital setting. When the cardiopulmonary arrest occurs, rapid response team comes to that specific location to provide immediate resuscitative care.

What You Can Do During Code Blue

Everyone can still play a role during code blue to prevent death, even an inexperienced staff member. Even if you focus on patient care on the rest of the patients while the staff and code blue team are focused on the unconscious patient, you are still doing your part. Someone has to still watch the other patients to ensure that another code blue is not needed.

When it is Your First Time Experiencing Code Blue

If it is your first time to experience a code blue, it is okay to stand back and observe. Do not feel as if you are useless. Observing is important so you know how the situation is handled and how you can do your part when you feel confident.

Do not try to handle a code blue if you have not been trained. There is no shame in observing and learning. It is important to ask questions after and not during. Do not distract the staff at work.

If you have been trained and you took part of code blue, discuss the experience with the team after and ask questions. See which areas you can improve in and how to be better. Your first time may not always go smoothly, but you will learn from it.

What are the Roles During Code Blue?

First responder:

  • Check for pulse and for responsiveness
  • If there’s no pulse and patient is unresponsive, call for help
  • Begin CPR after patient is placed on back in optimal position

Second responder:

  • Call the rapid response team
  • Bring the e-cart, which provides emergency equipment, to the unresponsive patient
  • The backboard that’s on the e-cart should be secured under the patient
  • Place airway on patient

If there’s a third responder, he/she will use the AED. Otherwise the two responders will focus on the AED until help arrives.

Ideally there’s 4-5 responders during the emergency situation. However, other staff members may be on break or be occupied with other patients and cannot leave at that moment. It is important to continue practicing mock drills and be prepared.T

Tips for Code Blue

Stay calm and speak with a loud clear voice for the staff members to understand you and your directions.

Get training with Basic Life Support and Advanced Cardiac Life Support as mandated by your state.

Provide a safe environment and minimize outside distraction. Don’t let other patients or visitors hover over to see what is happening.

Code Blue Stories

I had a patient that went downhill so fast. She was begging us to help her breathe but before you know it, her eyes rolled back and she went unresponsive. The code began and it was the longest code I’ve experienced, but she did not make it.
– Joe

Had a successful code where a patient coded during my first five minutes on the shift of course. He went flatline and unresponsive. He got intubated and everything. He was fine and made it through. At the end of the night, he was somehow walking and talking again.
– Linda

As a paramedic, I was not able to save one but when I was in the cardiac cath lab, they were all successfully revived. I believe the environment and timing plays a big role in a successful code.
– Patrick

Had a patient that went into asystole and he was coding. He crashed so fast but he also came back so fast. He wouldn’t believe us and thought we were trying to kill him. At least he made it.
– Kim