Code Blue

[NFOL]

Can someone please explain what pharmacists do when they go with the code team?

Thank you

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[a student]

I think it depends on the hospital. At mine, the pharmacist draws up things and hands them to the nurse administrating stuff.

 

[sakigt]

Can someone please explain what pharmacists do when they go with the code team?

Thank you

Take control of the med tray. Assemble the prefilled syringes, or draw up doses if needed. Hand to nurses and have flushes ready as well. Run to the accudose if additional meds are needed. Make suggestions. Keep track of when next epi is due. Make drips like levophed if you get the patient back. Facilitate delivery of rare meds like tpa. Once the code is over make sure the cart is labeled and call for it to be replaced.

 

[njac]

Take control of the med tray. Assemble the prefilled syringes, or draw up doses if needed. Hand to nurses and have flushes ready as well. Run to the accudose if additional meds are needed. Make suggestions. Keep track of when next epi is due. Make drips like levophed if you get the patient back. Facilitate delivery of rare meds like tpa. Once the code is over make sure the cart is labeled and call for it to be replaced.

This.

Also, referencing labs from earlier in the day (hyperK, hypoglycemia), info about pmh (I went to one code where I was the only person who knew the patient was S/p heart transplant), post intubation analgesia and sedation (if needed), help RNs titrate drips (especially if on the floor and patient can't go to ICU immediately)


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[gwarm01]

At my last hospital the ICU nurses generally ran the cart but I would draw up doses if needed. I would usually coordinate post-resuscitation meds, provide dosing/administration information, occasionally prepare an epi or amiodarone drip at bedside if needed. Basically take care of any medication needs since I had full access to Pyxis meds and could just take a verbal order for any drips.

 

[holymolys]

How common is having RPh being involved in code blues these days? Is this becoming a trend?

 

[bacillus1]

How common is having RPh being involved in code blues these days? Is this becoming a trend?

I would say 50-50. My old job had pharmacists on codes. My new one does not.

 

[njac]

How common is having RPh being involved in code blues these days? Is this becoming a trend?

I wouldn't say "becoming", but I'm sure there are some hospitals where pharmacists don't participate, but I can't state a percentage.

http://c.ymcdn.com/sites/www.nyschp.org/resource/resmgr/imported/Code Blue.pdf

http://m.aop.sagepub.com/content/42/4/469.short

Most of the papers outlining pharmacist participation in codes and resuscitation are describing overall duties and interventions in the ICU or ED.



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[confettiflyer]

Take control of the med tray. Assemble the prefilled syringes, or draw up doses if needed. Hand to nurses and have flushes ready as well. Run to the accudose if additional meds are needed. Make suggestions. Keep track of when next epi is due. Make drips like levophed if you get the patient back. Facilitate delivery of rare meds like tpa. Once the code is over make sure the cart is labeled and call for it to be replaced.

This.

Also, referencing labs from earlier in the day (hyperK, hypoglycemia), info about pmh (I went to one code where I was the only person who knew the patient was S/p heart transplant), post intubation analgesia and sedation (if needed), help RNs titrate drips (especially if on the floor and patient can't go to ICU immediately)

All this. I also can't emphasize enough the bridge pharmacy serves between the relative sparseness of the code cart and the ability to expedite agents from the pharmacy. I carry an in-house wireless and can dial up the compounding technician and have ________ at bedside within minutes.

I've done everything from hang back and wait for requests that don't come, down to operating the defibrillator because mashed potatoes hit the fan, sometimes.

 

[confettiflyer]

How common is having RPh being involved in code blues these days? Is this becoming a trend?

Every place I rotated through in school starting back in 2008 had pharmacists respond to codes except one really small hospital (<50 beds). I think it's really a function of institution and department size. If you can't spare a pharmacist...then no go.

 

[ChalupaBatman86]

They are the ones that get to yell "clear!"

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[Dalteparin]

In addition to what's been described, since I'm big I occasionally get asked to do compressions.

 

[njac]

In addition to what's been described, since I'm big I occasionally get asked to do compressions.

I have my students and residents do compressions at least once during the rotation.




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[rph3664]

I went on codes a few times when I worked at a small hospital in the late 1990s. My job mostly consisted of throwing Abbojects at the nurses and doctors.

 

[hurx]

I'm at a very small hospital, we have 2 inpatient pharmacists during most of the day and one overnight pharmacist. We mainly just draw up medications/make drips for codes


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[WVUPharm2007]

I used to hand out drugs, screw 'em together (i.e. the bicarb syringes), answer questions (i.e. "Can I push this IV mag?"), and be the runner if an urgent medication was needed from the pharmacy for whatever. It was usually mildly interesting to be a part of.

Then I got fired for cursing my boss out and now I count by 5s for a living in a part of North Philly where nobody speaks English.

 

[Pharmacyjoedotcom]

Can someone please explain what pharmacists do when they go with the code team?

Thank you

Hi Tamaratoto, Here is what I see as the pharmacist's role/responsibility at a code:

Role 1 - Assume responsibility for the provision of pharmacotherapy

- Locate/obtain necessary medications quickly and easily

- Calculate doses, rates, concentrations correctly

- Prepare and label medications appropriately

- Provide IV compatibility information

Role 2 - Actively participate in medical decision making

- Make treatment recommendations

- Determine the cause of deterioration

Role 3 - Anticipate patient and provider needs and prepare in advance to meet those needs

- Be the pessimist in the room and always plan for "what is the worst thing that could go wrong right now?"

Role 4 - Function as a knowledgeable team member

- Make an effort to know the purpose and location of the non-drug contents of the code cart

- Be aware of what is going on around you

I discuss this in more detail in my podcast:
Episode 1
Episode 2
Episode 90

Joe

 

[deleted723470]

My 1st code blue experience as a pharmacist student