Code Blue Short Film

[ChrisTheAwesome]

Not sure if it is the right forum but I didn't know where else to post this.
I am making a short film and I want to have a code blue scene. There will just be a blank screen though so all you will hear is the audio. I want to make it as realistic as I can so I would like to know things people would say/administer to the patient. So I know I want the nurse to come into the room asking if the patient wants some water and she notices a irregular heart beat. She then calls code blue down the hallway and it is then announced on the intercom. I want the patient to already be hooked up to the ECG machine before the nurse comes in. Then the nurse does CPR (not sure is she would remove the headboard as the ECG machine is already plugged in). The code team then comes in with the trolley. They say something like he's going into v-fib (I think that is the right term). The patients heart rate then goes really fast. They administer adrenaline and (drug that slows your heart rate down). The drug then slows the heart down too much and the patient flatlines. Then they try to use the defibulator on the patient (I know this part is inaccurate but unless a doctor/nurses is watching it should be fine).
Do tell me if this is the wrong forum. I just have no idea which forum I would post a question like this.

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[Tenk]

I assume by ecg machine you mean tele. An irregular heart beat does not necessarily require cpr. Not having a pulse requires cpr. V fib is pulseless and not just some tachyarrythmia. It requires immediate defibrillation, not epi and I’m guessing you mean a beta blocker for your second drug which wouldn’t be used in this situation unless refractory v fib with esmolol. If the patient is already in v fib they don’t have a pulse so having the distinction between that and asystole is pretty worthless if cpr is in progress and why you didn’t defribilate v fib and waited for asystole is bad.

Basically, none of what you said makes sense.

 

[DBV]

Headboard is for cpr not "ecg machine"

 

[WingedOx]

Just don't try to shock asystole. If even "The Resident" can figure that part out, there's no excuse for you.

 

[mehc012]

Not sure if it is the right forum but I didn't know where else to post this.
I am making a short film and I want to have a code blue scene. There will just be a blank screen though so all you will hear is the audio. I want to make it as realistic as I can so I would like to know things people would say/administer to the patient. So I know I want the nurse to come into the room asking if the patient wants some water and she notices a irregular heart beat. She then calls code blue down the hallway and it is then announced on the intercom. I want the patient to already be hooked up to the ECG machine before the nurse comes in. Then the nurse does CPR (not sure is she would remove the headboard as the ECG machine is already plugged in). The code team then comes in with the trolley. They say something like he's going into v-fib (I think that is the right term). The patients heart rate then goes really fast. They administer adrenaline and (drug that slows your heart rate down). The drug then slows the heart down too much and the patient flatlines. Then they try to use the defibulator on the patient (I know this part is inaccurate but unless a doctor/nurses is watching it should be fine).
Do tell me if this is the wrong forum. I just have no idea which forum I would post a question like this.

OK, so what you want to do is Google 'ACLS algorithm' and see which steps are recommended there for various scenarios (there aren't many, ACLS keeps it to a few main categories). Then basically piece out an order of events that makes sense and gets you to your goal. Could easily be something like "tele alarms start going off → code called → CPR initiated → team arrives, pt intubated, defib/pacer pads placed → some combination of continuous CPR + rhythm checks and drug administration every 2min, plus or minus shocking if you want it (and thus put the right rhythm for it) until everyone gives up and the pt is declared dead (since it sounds like that is what you were going for) or until normal rhythm returns."

Now, I'm confused by the fact that you are simultaneously trying to be so accurate that you include the headboard detail in a code scene that doesn't even have visuals (what exactly does it sound like to remove a headboard? Is there a universal sound?) and yet are fine with shocking a flatline, which at this point even many non-med people know isn't going to work. You should know that asking docs to back you up on that isn't going to work out very well. Btw, the headboard removal isn't for the rhythm monitoring, it's for airway control - lets someone stand at the head of the bed and head of the pt to do what needs doing to ensure the pt is able to breathe.

 

[ChrisTheAwesome]

OK, so what you want to do is Google 'ACLS algorithm' and see which steps are recommended there for various scenarios (there aren't many, ACLS keeps it to a few main categories). Then basically piece out an order of events that makes sense and gets you to your goal. Could easily be something like "tele alarms start going off → code called → CPR initiated → team arrives, pt intubated, defib/pacer pads placed → some combination of continuous CPR + rhythm checks and drug administration every 2min, plus or minus shocking if you want it (and thus put the right rhythm for it) until everyone gives up and the pt is declared dead (since it sounds like that is what you were going for) or until normal rhythm returns."

Now, I'm confused by the fact that you are simultaneously trying to be so accurate that you include the headboard detail in a code scene that doesn't even have visuals (what exactly does it sound like to remove a headboard? Is there a universal sound?) and yet are fine with shocking a flatline, which at this point even many non-med people know isn't going to work. You should know that asking docs to back you up on that isn't going to work out very well. Btw, the headboard removal isn't for the rhythm monitoring, it's for airway control - lets someone stand at the head of the bed and head of the pt to do what needs doing to ensure the pt is able to breathe.

So does the tele alarm alert the person on the intercom or would a nurse have to call a number or press a button or just call down the corridor? The idea was to have things such as the headboard said verbally in dialogue by the nurse or something such as "headboard removed". The reason behind shocking the patient when they have flatlined is the scene happens at the beginning on the short film. The idea is for the viewer to think the patient is dead and then it goes back in time to earlier that day and then it shows how the patient came to "die". However I want to repeate the death scene at the end of the short film but right at the end I want a defibrillator shock to work and the patient survives for a happy ending. Also would they put a oxygen mask over the patient? as when I looked at code blue simulations on YouTube some did and some didn't.

 

[ChrisTheAwesome]

Just don't try to shock asystole. If even "The Resident" can figure that part out, there's no excuse for you.

But is there anyway to survive once you are in asystole? I want the viewer to think that patient is dead then have them survive.

 

[ChrisTheAwesome]

I assume by ecg machine you mean tele. An irregular heart beat does not necessarily require cpr. Not having a pulse requires cpr. V fib is pulseless and not just some tachyarrythmia. It requires immediate defibrillation, not epi and I’m guessing you mean a beta blocker for your second drug which wouldn’t be used in this situation unless refractory v fib with esmolol. If the patient is already in v fib they don’t have a pulse so having the distinction between that and asystole is pretty worthless if cpr is in progress and why you didn’t defribilate v fib and waited for asystole is bad.

Basically, none of what you said makes sense.

So would this work? The patient goes into tachyarrythmia and the tele alarm goes off and a nurse comes in and does cpr. Then they administer adrenaline and a beta blocker and they gave the patient too much beta blocker so they go into V fib and then they try to use the defribilater.

 

[Tenk]

So would this work? The patient goes into tachyarrythmia and the tele alarm goes off and a nurse comes in and does cpr. Then they administer adrenaline and a beta blocker and they gave the patient too much beta blocker so they go into V fib and then they try to use the defribilater.

No

 

[mehc012]

So does the tele alarm alert the person on the intercom or would a nurse have to call a number or press a button or just call down the corridor? The idea was to have things such as the headboard said verbally in dialogue by the nurse or something such as "headboard removed". The reason behind shocking the patient when they have flatlined is the scene happens at the beginning on the short film. The idea is for the viewer to think the patient is dead and then it goes back in time to earlier that day and then it shows how the patient came to "die". However I want to repeate the death scene at the end of the short film but right at the end I want a defibrillator shock to work and the patient survives for a happy ending. Also would they put a oxygen mask over the patient? as when I looked at code blue simulations on YouTube some did and some didn't.

There's usually a button to call a code, and there's usually an overhead announcement "Code Blue, Rm###, Code Blue" or something similar. You probably wouldn't need to mention the headboard thing. In a hospital, they would definitely put a mask on the patient and use the bag to breathe for them...that's not quite an oxygen mask but it's probably what you meant. Often, the patient will be intubated during the code, which would be even more secure than the mask.
Honestly, if you look up Code Blue on Youtube there are tons of simulations and whatnot and you can get a feel for it.

 

[nlax30]

Many other videos on youtube to help you which is probably better than us trying to type out descriptions for ya.

 

[Cognovi]

So does the tele alarm alert the person on the intercom or would a nurse have to call a number or press a button or just call down the corridor? The idea was to have things such as the headboard said verbally in dialogue by the nurse or something such as "headboard removed". The reason behind shocking the patient when they have flatlined is the scene happens at the beginning on the short film. The idea is for the viewer to think the patient is dead and then it goes back in time to earlier that day and then it shows how the patient came to "die". However I want to repeate the death scene at the end of the short film but right at the end I want a defibrillator shock to work and the patient survives for a happy ending. Also would they put a oxygen mask over the patient? as when I looked at code blue simulations on YouTube some did and some didn't.

Movie makers are fixated on this shocking asystole business because of the drama: visual cue there's no heart beat, big intervention, visual cue for life restored. In reality, shocks are indicated for no pulse (a thing you feel and can't see) with a ventricular tachycardia or for ventricular fibrillation (fast rhythms that lay people probably can't tell apart from a normal rhythm). In reality, the intervention for asystole is pushing drugs (much less dramatic than shocking). In reality, the cue for life restored is feeling a pulse (having a rhythm does not mean having a pulse, ie, pulseless electrical activity).

 

[siliso]

 

[ChrisTheAwesome]

I just want to run it past you guys just in case because I think it is technically accurate but i'm not 100% sure. Here is my latest script. Would it work?

Script
Wife: little ella wants to see how you are doing
(Old tele machine bleeping)
Andrew: (growning in suddern pain)
Wife: Andy? Andy!!
(tele goes into v-tach)
Nurse: (door opens) MR Hudson do you need me to..... (calls down coridoor) Code Blue in room 5B
Wife: I was just talking to him and -
Nurse: It's OK, we will deal with this. Mr Hudson, Mr Hudson (Shakes him)
(sound of nurse putting headboard down)
Nurse: Please could you stand aside.
Tanoy: Code Blue in St Mary's ward, room 5B, code blue St Mary's ward, room 5B, I repeate, code blue room 5B St mary's ward
Wife: What's happening
Nurse: He has gone into v-tach which is a form of cardiac arrest
Wife: oh god
Nurse: (Starts CPR)
Wife: Andy, can you hear me
Nurse: Please could you clear the doorway miss
Silence......(You hear someone come throught the door)
Random Guy 1: I'll take over (CPR switches)
(door openes again and hear wheels of trolly)
Code leader: We are going to start with 2 leters of O2
Random guy 2: can you hold open the airway
Nurse: holing open the airway
Code leader: Lydia can you get us access
Wife: What are you doing to him
Code leader: Ben could you put the defibulation pads on him
Random guy 3: We are giving him oxagen
Code leder: I would like Samual to record
Wife: Stop it your hurting him
Random guy 3: CPR is helping him to breave
Lydia: I have IV access
code leader: good, lets start with a charge of 200 jewls
Wife: (becoming more agetated) stop it
Random guy 3: Sorry but I am going to have to ask you to leave the room
Ben: charging
Wife: Im not leaving
Random guy 3: (shouting) can someone call security please
Ben: shock ready, clear
(Shock)
Wife: Andy!!!
Wife: Get off of me
Code leader: Check for pulse
Random guy 3: can someone please call security
Code leader: adminster 50 micrograms of adrennaline
Lydia: administering 50 micrograms of adrenaline
(Door opens) Security guard: Please can you leave the room miss
Lydia: 50 micrograms of adrenaline administered
Wife: Dont you dare touch my daughter
(Baby starts crying)
Code leader: Shock patient again with 300 jewls
Ben: charging
Wife: get off of me (in tears)
Ben: ready, clear the patient
(Shock)
Wife: NO (yelling)
Code leader: Check for pulse
(Pulse slows down)
Nurse: oh god
Code leader: we'are loosing him
Wife: ANDY!!!
(everything goes quiet as patient goes asystole)

 

[ChrisTheAwesome]

There's usually a button to call a code, and there's usually an overhead announcement "Code Blue, Rm###, Code Blue" or something similar. You probably wouldn't need to mention the headboard thing. In a hospital, they would definitely put a mask on the patient and use the bag to breathe for them...that's not quite an oxygen mask but it's probably what you meant. Often, the patient will be intubated during the code, which would be even more secure than the mask.
Honestly, if you look up Code Blue on Youtube there are tons of simulations and whatnot and you can get a feel for it.

I just want to run it past you guys just in case because I think it is technically accurate but i'm not 100% sure. Here is my latest script. Would it work?

Script
Wife: little ella wants to see how you are doing
(Old tele machine bleeping)
Andrew: (growning in suddern pain)
Wife: Andy? Andy!!
(tele goes into v-tach)
Nurse: (door opens) MR Hudson do you need me to..... (calls down coridoor) Code Blue in room 5B
Wife: I was just talking to him and -
Nurse: It's OK, we will deal with this. Mr Hudson, Mr Hudson (Shakes him)
(sound of nurse putting headboard down)
Nurse: Please could you stand aside.
Tanoy: Code Blue in St Mary's ward, room 5B, code blue St Mary's ward, room 5B, I repeate, code blue room 5B St mary's ward
Wife: What's happening
Nurse: He has gone into v-tach which is a form of cardiac arrest
Wife: oh god
Nurse: (Starts CPR)
Wife: Andy, can you hear me
Nurse: Please could you clear the doorway miss
Silence......(You hear someone come throught the door)
Random Guy 1: I'll take over (CPR switches)
(door openes again and hear wheels of trolly)
Code leader: We are going to start with 2 leters of O2
Random guy 2: can you hold open the airway
Nurse: holing open the airway
Code leader: Lydia can you get us access
Wife: What are you doing to him
Code leader: Ben could you put the defibulation pads on him
Random guy 3: We are giving him oxagen
Code leder: I would like Samual to record
Wife: Stop it your hurting him
Random guy 3: CPR is helping him to breave
Lydia: I have IV access
code leader: good, lets start with a charge of 200 jewls
Wife: (becoming more agetated) stop it
Random guy 3: Sorry but I am going to have to ask you to leave the room
Ben: charging
Wife: Im not leaving
Random guy 3: (shouting) can someone call security please
Ben: shock ready, clear
(Shock)
Wife: Andy!!!
Wife: Get off of me
Code leader: Check for pulse
Random guy 3: can someone please call security
Code leader: adminster 50 micrograms of adrennaline
Lydia: administering 50 micrograms of adrenaline
(Door opens) Security guard: Please can you leave the room miss
Lydia: 50 micrograms of adrenaline administered
Wife: Dont you dare touch my daughter
(Baby starts crying)
Code leader: Shock patient again with 300 jewls
Ben: charging
Wife: get off of me (in tears)
Ben: ready, clear the patient
(Shock)
Wife: NO (yelling)
Code leader: Check for pulse
(Pulse slows down)
Nurse: oh god
Code leader: we'are loosing him
Wife: ANDY!!!
(everything goes quiet as patient goes asystole)

 

[siliso]

Sub epinephrine for adrenaline. This would not be given until 2 shocks done, ca 4 mins. For extra realism you have a nurse or chaplain escort the wife out with reassurances, if this fits with your dramatic purpose.

The respiratory folks would be bagging with an ambu bag, not 2 liters O2. Code leaders do not normally become distressed or cry We’re losing him with asystole - they’d proceed then to give the epinephrine. If persistent asystole and nothing working, they would think through the H and Ts of asystole and ask for opinions and eventually say “we’re going to call the code if no pulse at next check, everyone agreed?” Hope that helps.

 

[ChrisTheAwesome]

Sub epinephrine for adrenaline. This would not be given until 2 shocks done, ca 4 mins. For extra realism you have a nurse or chaplain escort the wife out with reassurances, if this fits with your dramatic purpose.

The respiratory folks would be bagging with an ambu bag, not 2 liters O2. Code leaders do not normally become distressed or cry We’re losing him with asystole - they’d proceed then to give the epinephrine. If persistent asystole and nothing working, they would think through the H and Ts of asystole and ask for opinions and eventually say “we’re going to call the code if no pulse at next check, everyone agreed?” Hope that helps.

Thanks. That has helped a lot. What I was going for with the wife is that she was refusing to leave and therefore had to have security called on her. She was physically struggling with the security guard as she didn't like what they were doing to her husband. The main reason for this it to add drama as without it it may seem a little too professional/there wouldn't be too much feelings and it would be a bit too calm. I kind of like the line "I think weare loosing him" so would any other person in the room say it. Maybe the nurse? But if it is a bit far fetched/unrealistic then I can take it out. I am from England so all the people will be English but I just thought that this forum could be american so is everything accurate from an English point of view?
Thanks again as your response was really helpful.

 

[mehc012]

Thanks. That has helped a lot. What I was going for with the wife is that she was refusing to leave and therefore had to have security called on her. She was physically struggling with the security guard as she didn't like what they were doing to her husband. The main reason for this it to add drama as without it it may seem a little too professional/there wouldn't be too much feelings and it would be a bit too calm. I kind of like the line "I think weare loosing him" so would any other person in the room say it. Maybe the nurse? But if it is a bit far fetched/unrealistic then I can take it out. I am from England so all the people will be English but I just thought that this forum could be american so is everything accurate from an English point of view?
Thanks again as your response was really helpful.

You'd be more likely to hear something like 'somebody bag him' than 'hold open the airway', if that helps.

 

[xffan624]

Thanks. That has helped a lot. What I was going for with the wife is that she was refusing to leave and therefore had to have security called on her. She was physically struggling with the security guard as she didn't like what they were doing to her husband. The main reason for this it to add drama as without it it may seem a little too professional/there wouldn't be too much feelings and it would be a bit too calm. I kind of like the line "I think weare loosing him" so would any other person in the room say it. Maybe the nurse? But if it is a bit far fetched/unrealistic then I can take it out. I am from England so all the people will be English but I just thought that this forum could be american so is everything accurate from an English point of view?
Thanks again as your response was really helpful.

For someone who speaks English as their native language, you sure have a lot of typos and misspellings in your writing.

 

[wholeheartedly]

For someone who speaks English as their native language, you sure have a lot of typos and misspellings in your writing.

British English and yes, it seems like he's typing phonetically what he's heard on the videos he's been watching.

 

[ChrisTheAwesome]

I wasn't really concentrating on spelling as it doesn't really matter as long as the words are readable by the voice actors but I've fixed them anyway. So would this work?



Wife: little Ella wants to see how you are doing
(Old tele machine bleeping)
Andrew: (groaning in sudden pain)
Wife: Andy? Andy!!
(tele goes into v-tach)
Nurse: (door opens) MR Hudson do you need me to..... (calls down corridor) Code Blue in room 5B
Wife: I was just talking to him and -
Nurse: It's OK, we will deal with this. Mr Hudson, Mr Hudson (Shakes him)
(sound of nurse putting headboard down)
Nurse: Please could you stand aside.
Tanoy: Code Blue in St Mary's ward, room 5B, code blue St Mary's ward, room 5B, I repeat, code blue room 5B St Mary’s ward
Wife: What's happening
Nurse: He has gone into v-tach which is a form of cardiac arrest
Wife: oh god
Nurse: (Starts CPR)
Wife: Andy, can you hear me
Nurse: Please could you clear the doorway miss
Silence......(You hear someone come through the door)
Random Guy 1: I'll take over (CPR switches)
(door opens again and hear wheels of trolley)
Code leader: Can somebody bag him
Code leader: Lydia can you get us access
Wife: What are you doing to him
Code leader: Ben could you put the defibrillation pads on him
Random guy 3: We are giving him oxygen
Code leader: I would like Samuel to record
Wife: Stop it you’re hurting him
Random guy 3: CPR is helping him to breathe
Lydia: I have IV access
code leader: good, let’s start with a charge of 200 jewels
Wife: (becoming more agitated) stop it
Random guy 3: Sorry but I am going to have to ask you to leave the room
Ben: charging
Wife: I’m not leaving
Random guy 3: (shouting) can someone call security please
Ben: shock ready, clear
(Shock)
Wife: Andy!!!
Wife: Get off of me
Code leader: Check for pulse
Random guy 3: can someone please call security
Code leader: administer 1 milligram of epinephrine
Lydia: administering 1 milligram of epinephrine
(Door opens) Security guard: Please can you leave the room miss
Lydia: 1 milligram of epinephrine administered
Wife: Don’t you dare touch my daughter
(Baby starts crying)
Code leader: Shock patient again with 300 jewels
Ben: charging
Wife: get off of me (in tears)
Ben: ready, clear the patient
(Shock)
Wife: NO (yelling)
Code leader: Check for pulse
Code leader: OK, administer 50 micrograms of adrenaline
(Pulse slows down)
Lydia: administering 50 micrograms of adrenaline
Nurse: Oh god
Wife: ANDY!!!
(everything goes quiet as patient goes asystole)