NEW and Expanded Code Green This is confidential and protected quality improvement information per RCW 4.24.250 and 70.41.200.
Objectives • Describe New Code Green • Identify where Code Green is available • Describe how to activate Code Green • Describe what to expect from Code Green This is confidential and protected quality improvement information per RCW 4.24.250 and 70.41.200.
Why NEW Code Green? • Many critical care areas (ED, Cath Lab, OR) have most, but not all, providers for a “coding” patient. They do not need a full code blue response. • Need immediate additional resources • Ad-hoc paging can result in delays • House-wide awareness • Ad-hoc paging can miss critical personnel
Why NEW Code Green? • Full Code Blue team response can physically overwhelm these critical care areas • Full Code Blue team response pulls many providers, unnecessarily, from their ongoing patient care
What is Code Green? • A modified Code Blue response • Includes a subset of the Code Blue Team • Provides additional personnel to existing critical care teams • Activating team should include a physician team leader capable of running a code team
Where Code Green will be available Expanding beyond the OR!! • Available in: • OR • ED • PACU • Cardiac Catheterization Lab
Which patients qualify for Code Green? A patient in impending or current cardiopulmonary failure or arrest • Acutely Unstable Airway • Respiratory Failure • Circulatory Failure • Acutely Altered Mental Status • At risk for failure of A,B,or C • For high acuity medical emergencies outside of scope
Code Green: Activation • Team leader or nurse (if team leader unavailable) decides if Code green needs to be activated • 7-9999- tell to activate Code Green and give specific location • Page will be announced overhead • Page for “Code Green” will be sent to subset of Code Blue Team
Activation of Code green ****Know what level of response occurs from activating buttons in rooms (not standard in all parts of hospital) Blue button- activates code blue by signaling telecommunications Red button- in the OR this is for anesthesia assistance (internal call) Green button- staff assistance; NOT an emergency CODE GREEN IS ACTIVATED BY CALLING 7-9999 and giving location
Code Green: Who Comes • PICU Fellow • PICU Charge RN • NICU Charge RN • Anesthesia resident • RT • Shift Administrator • PICU Attending • Paged, not always in house
Code Green: Response • All Team Members respondSTAT • Initial Critical Care Team responsibilities • Identify selves to Code Green team • Review patient course • Identify how Code Green Team can assist • Code Green Team responsibilities • Dress in surgical jumpsuitif called to OR • Identify self on arrival and discuss role • Help assess, assist current team • Suggest additional considerations • Jointly discuss patient disposition • PICU RN will ask if eligible for eCPR I’m Dr. Roberts, PICU attending. How can I help?
Code Green documentation • Documented on Code blue sheet • Form is copied and QI form is completed and copied- given to CNS or manager on unit
Code Green PDCA • Activations will be reviewed in Code Blue Committee • In the future, simulations will be planned to work on Code Green teamwork between Code Green team members and initiating unit
Code Green Summary • Available in ED, OR, PACU, Cath Lab • Critical care team (including physician team leader) already in place, need additional help • Patient in impending/active cardiopulmonary failure • Call 7-9999 with location • STAT response of: • PICU fellow, PICU charge RN, NICU charge RN, Anesthesia, RT, Shift Administrator and PICU attending (if in house)
Go-live August 2, 2010 Questions This is confidential and protected quality improvement information per RCW 4.24.250 and 70.41.200.