1. Before the Code Blue
Team Arrives
Are you comfortable knowing what to do
before the Code Blue team arrives?
Fawn Olson RN, CCRN, MICU/CCU
Nancy Yazici RN, CCRN-CMC, MICU/CCU
Yvonne Lin-Chen, MN, RN, Nurse Educator/Sim Lab

2. Training Objectives
• Participants will be familiar and able to demonstrate
current AHA 2010 BLS Guidelines
• Participants will understand the Crisis Resource
Management (CRM) concept and be able to utilize CRM
communication techniques in order to demonstrate
teamwork BEFORE code blue team arrives.
• Participants will understand the role of each responder
(responder 1,2,3&4)

3. AHA 2010 BLS Guidelines
C – Compressions
Rate 30:2
• At least 2 inches deep
• At least 100 per minute
• Allow complete chest recoil
A – Airway
Head tilt-chin lift
Suction available if needed
B – Breathing
Use Ambu bag, chest rise, O2 wide open (16L)
D – Defibrillation
AED mode, correct placement of pads, be ready to shock if advised

4. Crew Resource Management
(CRM)

5. CRM continued…
• Call for help early
• Activate Code Blue team (internal 911)
• Establish role clarity
• Ensure responder roles (1,2,3 &4+) are filled.
• Knowing environment
• Move out extra furniture. Move bed away from wall
• Communicate effectively
• Don’t be afraid to speak up
• Closed-loop communicate (read back/repeat back)

6. 1st Responder
(AllBLScertifiedstaff)
• Verify patient is pulseless
• Activate internal 911 (code blue)
• Start chest compressions
• Delegate roles of subsequent responders entering room
• Swap role with 3rd responder (airway) every 2 minutes

7. 2nd Responder
• Follow through that the internal 911- Code Blue has been
activated
• Bring in crash cart (make sure to unplug the cord from the
wall first)
• Turn on AED/Defibrillator first, THEN, apply the pads. (this
is so time is not wasted while the machine is warming up).
• Insert back board to ensure high quality compressions are
being provided as early as possible.
• Deliver shock if advised by Zoll defibrillator.

8. 3rd Responder
• Airway mangement: use the Ambu bag from the crash cart
• Confirm Ambu bag is inflated
• Turn up O2 all the way (wide open)
• Pull bed out from away the wall (remain at head of bed)
• Swap role with 1st responder (compressor) every 2
minutes

9. 4th Responder (if available)
• Follow through to make sure everything is being done:
• make sure internal 911- code blue is called
• someone is doing compressions
• there is a backboard underneath the patient (high quality
compressions is very important)
• AED is turned on, and PADS applied properly with right location
• Someone is managing the airway, and the O2 is up
• If above is all done, then 4th responder will be the
RECORDER.