As events that happen beyond a medical facility’s control and impede a planned health care delivery, emergencies require an immediate and appropriate response. Thus, in hospitals, administrators, chief nursing executives, nurses, and other medical staff are responsible for the development of specific plans dedicated to emergency management [7]. Being in charge of correct decision-making and positive outcomes for patients affected by it, hospitals constantly evaluate their strategies of emergency response for their subsequent improvement.
Code Blue is an emergency code used by clinicians to address a patient’s critical status due to cardiopulmonary arrest, respiratory issues, chest pain, presyncope, and mental status changes [1]. As a matter of fact, hospitals traditionally have Critical Care Code Blue teams that provide rapid response when an emergency is announced on the basis of evidence and experience [4]. They immediately respond to life-threatening changes in a person’s status 24 hours a day, 7 days a week, saving lives and reducing potential disabilities [8]. At the same time, the Code Blue Team multidisciplinary committees review and monitor response procedures, processes, and policies in order to address new opportunities for efficiency improvement.
In general, the resuscitation team’s Code Blue interventions include performing chest compression, stabilizing the airway, assessing and restoring a perfusing cardiac rhythm, and treating the underlying reasons for the emergency [8]. At the same time, such practices imply multiple potential risks and health safety concerns both for clinicians and patients. First of all, professionals’ risks may be divided into several categories – infectious, electrical, musculoskeletal, chemical, irradiative, and psychological [4]. At the same time, challenges related to the resuscitation process may include misunderstanding due to poor communication within a team and a lack of skill related to the resuscitation process.
As a matter of fact, health care professionals should evaluate all risks, clinical appropriateness, and benefits of resuscitation for patients before making it [2]. Thus, it is not relevant in the case of the dying process and is prohibited when a patient consciously makes a DNR order in advance [1]. Moreover, there are risks for patients as well, including the occurrence of harmful side effects, such as hypoxic brain damage, internal organ damage, or rib fracture. Thus, taking into consideration that an emergency is a fragile condition and outcomes are not always positive, the patient’s family member may require documentation in order to be certain that the highest quality care was provided [3].
In order to minimize these risks, there are several fundamental strategies that any medical facility should consider. First of all, clearly defined guidelines should be elaborated on by clinical governance, and all medical staff should be properly aware of them through efficient education and training programs to manage potential risks and avoid failures due to misunderstanding. Subsequently, the practice of documentation should be introduced to ascertain quality care and communicate the health care concerns of patients and their families. Quality evaluation for the improvement of the Code Blue functionality within medical settings includes two phases – real-time data collection for expert-led debriefing and practice with instant feedback [5]. In addition, the proper functioning of all medical inventory and the use of protective equipment should be monitored. Moreover, stress management, support within an emergency team, and the establishment of proper communication are essential to cope with professional burnouts and act in a coordinated manner. At the same time, team leaders should be responsible for control over guidance, following and efficient communication between members to make sure that all professionals know their roles and activities in their frameworks.
References
Brennan D. What is a code blue? [Internet]. WebMD, 2021. Web.
General Medical Council. Cardiopulmonary resuscitation (CPR). [Internet]. Web.
McNamar S. Code Blue litigation – legal issues in cardiac arrest documentation. [Internet]. PRO Revital code BLUE iQ. Web.
Monangi S, Setlur R, Ramanathan R, Bhasin S, Dhar M. Analysis of functioning and efficiency of a blue code system in a tertiary care hospital. Saudi J Anaesth, 2018;12:245-249.
Risaliti C, Evans K, Buehler J. Decoding Code Blue: a process to assess and improve code team function. Resuscitation, 2018; 122: 15-16.
Vindigni SM, Lessing JN, Carlbom, DJ. Hospital resuscitation teams: a review of the risks to the healthcare worker. J Intensive Care, 2017; 5(59): 1-8.
Watts M. Emergency situations: the hospital is prepared, but are your critical suppliers? [Internet]. Hospital News; Web.
Winnipeg Regional Health Authority. WRHA Adult Critical Care Code Blue Standardization Committee [Internet]. Web.