MediMike Posted February 1, 2021 Share Posted February 1, 2021 I'm currently working MICU/SICU at a large community hospital in the PNW. Management of codes is a little hazy as our ED team is contractually required to respond but we prefer to manage our own patients (clearly), so I'm looking at initiating a trial of an ICU specific code team. Ideally I'd collect some data re: current outcomes and nursing/staff satisfaction prior to enacting a change to allow an assessment of a difference in those variables. Anyone have experience with this? I have a set-up for roles in mind but it seems like it may be a struggle to get things off the ground in the midst of COVID and our Code Blue committee has effectively disbanded (ridiculous). I'm looking for some sort of validated survey to assess confidence/comfortableness in code team response to allow a before/after evaluation. Side note: Is there a formalized code debriefing form you like to use? I normally wing it and it got a little wild tonight, angry RT started tossing blame around which is never the goal Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted February 2, 2021 Share Posted February 2, 2021 At my old level III trauma center job, the ED handled all codes on the 1st floor & outside, i.e. ED, imaging, lobby, parking lot, etc. The hospitalists handled all codes in all in-patient units (though L&D was kinda vague). I'm surprised that the ED folks are coming to the floor. We never did any formal post-code review. Quote Link to comment Share on other sites More sharing options...
MediMike Posted February 2, 2021 Author Share Posted February 2, 2021 5 hours ago, ohiovolffemtp said: At my old level III trauma center job, the ED handled all codes on the 1st floor & outside, i.e. ED, imaging, lobby, parking lot, etc. The hospitalists handled all codes in all in-patient units (though L&D was kinda vague). I'm surprised that the ED folks are coming to the floor. We never did any formal post-code review. Until my group was created there wasn't anyone in house to cover to ICU it was a single doc covering 4 hospitals. Now we are on-site overnight at the big hospital but the ED still has an obligation to respond and the CMO appears to have an issue with APPs managing codes (sure, take care of the sickest dang patients in the building until they're dead and all of a sudden they're too complicated). I'm working on getting it changed as it becomes a bit of a Charlie Foxtrot when the ED doc comes up and I've got a patient on an IABP w/ multiple infusions going that his/her nursing staff can't spell. (Nothing against the ED just a different world). And if I can work it into something publishable even better... The debriefs haven't been adopted in a lot of places but I've found them to be extremely helpful in getting teaching points in, as well as helping folks talk through some issues, especially if it was a tough resus. AHA currently recommends them as good practice, some studies showed an improvement in quality of CPR as well as survival outcomes...others not so much Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted February 3, 2021 Share Posted February 3, 2021 Makes perfect sense. The ED is much more about airway management and getting venous access and 1st & 2nd line drugs and trying to understand an undifferentiated patient. We ED providers and the ED nurses just aren't going to be familiar with IABP's nor all of the infusions you folks use. 1 Quote Link to comment Share on other sites More sharing options...
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