Code Blue

Question 1

Code Blue

Answer 1

in an emergency

Question 2

Race team

Answer 2

purpose is to prevent an emergency from happening

Question 3

Code blue roles (7)

Answer 3

1) Lead
-usually a physician

2) Recorder

3) Airway
-in a larger centre, may be an RT

4) Medications

5) Compressions

6) Crash cart

7) Runner

Question 4

Defibrillator mode (3)

Answer 4

1) Cardioversion
-big

2) Defib
-big

3) Pacing
-small

Question 5

What mode is default mode of the defibrillator?

Answer 5

defib

Question 6

Button to switch to cardioversion

Answer 6

SYNC

Question 7

Defibrillation

Answer 7

method of terminating VF and pulseless VT

passage of DC electrical shock to depolarize the cells of the myocardium to allow the SA node to resume the role of pacemaker

Question 8

Monophasic defibrillators

Answer 8

deliver energy in 1 direction

Question 9

Biphasic defibrillators

Answer 9

deliver energy in 2 directions

Question 10

What should happen after the initial shock of defibrillation is delivered?

Answer 10

restart CPR

Question 11

Synchronized Cardioversion

Answer 11

choice of therapy for hemodynamically unstable ventricular or supraventricular tachydysrhythmias

synchronized circuit delivers a counter shock on the R wave of the QRS complex of the ECG

synchronizer switch must be turned ON

Question 12

Is a patient is unstable, what would be prioritized?
a) meds
b) cardioversion

Answer 12

b) cardioversion

Question 13

What do you give before cardioversion?

Answer 13

pain meds and sedation

Question 14

Major similarities between defibrillation and cardioversion (2)

Answer 14

1) use lots of energy

2) stop the heart

Question 15

Biggest difference between defibrillation and cardioversion

Answer 15

cardioversion - shock is delayed so that it isn’t hitting during the relative refractory period (over the T wave)

Question 16

What time frame should cardioversion be done within?

Answer 16

first 48 hours

after this, increased risk of blood clots, which you would be helping to transport around the body

Question 17

Pacing

Answer 17

used to pace the heart when the normal conduction pathway is damaged or diseased

pacing circuit consists of a power source, 1 or more conducting (pacing) leads, and the myocardium

can be used to prevent bradycardia or tachycardia rhythms

Question 18

Start pacemaker at ___ milliamps

Answer 18

10

Question 19

Pacemaker spike

Answer 19

pace until you get QRS complex

want complex after every pacer spike

meaning there was enough energy to cause depolarization

if not, not giving enough energy

Question 20

Pacer/implant types (4)

Answer 20

1) Temporary Transcutaneous Pacemaker

2) Temporary Transvenous Pacemaker

3) Permanent Pacemaker

4) Implantable Cardioverter Defibrillator (ICD)

Question 21

Temporary Transcutaneous Pacemaker

Answer 21

with pads on tissue

non-invasive

skin should be clean and dry, may need to shave hair

Question 22

Temporary Transvenous Pacemaker

Answer 22

implanting temporary wires during surgery

e.g. problem with SA node and/or AV node - plant wires where needed

Question 23

Permanent Pacemaker

Answer 23

permanent device

Question 24

Implantable Cardioverter Defibrillator (ICD)

Answer 24

for someone that’s had a heart attack before

can read rhythm and defibrillate

Question 25

Assessing stability of patient

Answer 25

CAB vitals neuro - LOC

Question 26

Neuro LOC

Answer 26

Orientation Motor function Pupillary response

Question 27

T or F: A patient can be alert and lethargic.

Answer 27

FALSE

Question 28

T or F: A patient can be oriented and drowsy

Answer 28

TRUE

Question 29

Lethargic (somnolent)

Answer 29

drowsy, appropriate but thinking is slow, inattentive, decrease in spontaneous movement

Question 30

Obtunded

Answer 30

difficult to arouse, confused when aroused, speech mumbled, incoherent, monosyllabic, requires constant stimulation

Question 31

Stupor or semi-coma

Answer 31

only responds to physical stimulation, responds to pain, appropriate motor response, groans, reflexes intact

Question 32

Coma

Answer 32

completely unconscious, no response to pain

Question 33

Light coma

Answer 33

some reflex activity, no purposeful movement

Question 34

Deep coma

Answer 34

no motor response

Question 35

LOC assessment tool

Answer 35

Glasgow Coma Scale

Question 36

GCS score of 15

Answer 36

fully alert and oriented

Question 37

GCS of 8 or less

Answer 37

endotracheal intubation to protect the airway (coma)

Question 38

Potential causes of unresponsiveness (4)

Answer 38

1) Neuro 2) Cardio 3) Resp 4) Endocrine

Question 39

Neuro causes of unresponsiveness (3)

Answer 39

1) stroke 2) seizure 3) trauma

Question 40

Cardio causes of unresponsiveness (3)

Answer 40

1) MI 2) Dysrhythmias 3) Cardiac arrest

Question 41

Resp causes of unresponsiveness (2)

Answer 41

1) pulmonary embolism 2) respiratory arrest (e.g. choking, opioid overdose)

Question 42

Endocrine cause of unresponsiveness (1)

Answer 42

1) hypoglycemia

Question 43

You walk into a patient’s room, and they are unresponsive. What do you do?

Answer 43

shake to see if they’re awake call for help no pulse —> compressions

Question 44

Definite Pulse & Normal Breathing

Answer 44

Vital Signs Assess Responsiveness Glasgow Coma Scale Bloodwork/Imaging Tests e.g. stroke/TIA, slow brain bleed, medication

Question 45

Definite Pulse & No Breathing

Answer 45

‘C’ Check for pulse; pulse is palpable, but no breathing or breathing is not normal ‘A’ (Airway): Open airway ’B’ (Breathing): Bag Valve Mask *1 breath every 5-6 seconds *pulse check every 2 minutes e.g. obstruction, inadequate respiratory effort, medications (opioids)

Question 46

No PULSE

Answer 46

’C’: Circulation No pulse – IMMEDIATE CHEST COMPRESSIONS -push hard & fast (100-120 compressions per minute) -depth of at least 2 inches (5cm) -allow chest recoil -minimize interruptions in compressions ‘A’ Airway: Open airway ’B’ Breathing: Bag Valve Mask (BVM) -> 30:2

Question 47

What does excellent CPR mean?

Answer 47

good compression AND recoil

Question 48

What do you do when the Code Team arrives?

Answer 48

give information if giving compressions, let somebody else takeover and give report to the code team