Code Blue Simulation Research Articles

Code blue: overcoming the fear.

Code blue: overcoming the fear.

Supporting physiology learning: the development of interactive concept-based video clips

the accommodation of diverse student learning approaches and maintenance of good academic outcomes are often difficult to achieve in university courses, particularly where large classes are concerned. These issues become even more significant when dealing with first-year students in science courses

Improving Code Team Performance and Survival Outcomes

To determine whether implementation of Composite Resuscitation Team Training is associated with improvement in survival to discharge and code team performance after pediatric in-hospital cardiopulmonary arrest. We conducted a prospective observational study with historical controls at a 302-bed, quaternary care, academic children's hospital. Inpatients who experienced cardiopulmonary arrest between January 1, 2006, and December 31, 2009, were included in the control group (123 patients experienced 183 cardiopulmonary arrests) and between July 1, 2010, and June 30, 2011, were included in the intervention group (46 patients experienced 65 cardiopulmonary arrests). Code team members were introduced to Composite Resuscitation Team Training and continued training throughout the intervention period (January 1, 2010-June 30, 2011). Training was integrated via in situ code blue simulations (n = 16). Simulations were videotaped and participants were debriefed for education and process improvement. Primary outcome was survival to discharge after cardiopulmonary arrest. Secondary outcome measures were 1) change in neurologic morbidity from admission to discharge, measured by Pediatric Cerebral Performance Category, and 2) code team adherence to resuscitation Standard Operating Performance variables. The intervention group was more likely to survive than the control group (60.9% vs 40.3%) (unadjusted odds ratio, 2.3 [95% CI, 1.15-4.60]) and had no significant change in neurologic morbidity (mean change in Pediatric Cerebral Performance Category 0.11 vs 0.27; p = 0.37). Code teams exposed to Composite Resuscitation Team Training were more likely than control group to adhere to resuscitation Standard Operating Performance (35.9% vs 20.8%) (unadjusted odds ratio, 2.14 [95% CI, 1.15-3.99]). After adjusting for adherence to Standard Operating Performance, survival remained improved in the intervention period (odds ratio, 2.13 [95% CI, 1.06-4.36]). With implementation of Composite Resuscitation Team Training, survival to discharge after pediatric cardiopulmonary arrest improved, as did code team performance. Demonstration of improved survival after adjusting for code team adherence to resuscitation standards suggests that this may be a valuable resuscitation training program. Further studies are needed to determine causality and generalizability.

Saving Patient Ryan: using in situ simulation to improve code blues

Timely resuscitation efforts are critical to survival when a patient codes. Feedback from respiratory therapists, ICU charge nurses, and emergency room physicians indicates that when the code blue team arrives resuscitation efforts are not always in progress, a clear leader is not established, and clear communication does not always occur. Biannual recertification of BLS and ACLS has not been sufficient to ensure efficiency of code blue responsiveness. Neither have annual code blue simulation events.

Testing a Mnemonic on Response Skills during Simulated Codes

BackgroundBaccalaureate nursing students rarely have the opportunity to practice emergency response skills. Simulation gives students the ability to practice emergency procedures in an environment that is safe. MethodNursing students’ skills accuracy and confidence ratings were assessed before and after an instructional module that incorporated a mnemonic, named ABCD-COPIME, to improve emergency response techniques to a simulated code blue scenario. Seven nursing students completed 7 trials of responding to a code blue simulation. After each trial, skill accuracy was assessed with a skills checklist, and after Trials 1, 4, and 7, each student’s confidence was measured by self-report. A 20-minute intervention introducing the ABCD-COPIME mnemonic was inserted after Trial 3. ResultsBoth skills accuracy and self-reported confidence ratings significantly increased after introduction of the mnemonic (95% improvement in mean skills accuracy scores). Furthermore, analyses revealed that these changes were not due to practice effects. ConclusionThis study supports the accumulating body of evidence that suggests that simulated training exercises are important for improving skills and confidence in responding to emergency situations. Moreover, results suggest that the ABCD-COPIME mnemonic training technique substantially improves both the skills accuracy of students and their self-reported confidence when responding to a code blue simulation.

Miller's Anesthesia, 6th Edition.

Miller's Anesthesia, 6th Edition.