Medical Emergencies/Cardiopulmonary Resuscitation

Introduction

SME: Medical Director
Last Review Date: 6 /6/07

In the event of a life-threatening medical emergency, UTHCPC provides patients with basic life support and immediate transfer to a facility to serve their emergency needs.

Advance directive

If the patient has an Out of Hospital Do Not Resuscitate (DNR) order see below:

UTHCPC honors DNR orders, if and only if, notice of the directive is provided

Notice may be in the form of:

A completed DNR form

An officially recognized DNR identification device such as a bracelet or pendant

Exception: If a patient who has executed a DNR order, stops breathing under unnatural or suspicious circumstances, the DNR is automatically revoked and CPR is applied. For more information, see Advance Directives.

Acute medical assessment

Nursing staff immediately notifies the physician and nursing supervisor when the patient is assessed to be in need of acute medical care.

Advanced life support

UTHCPC does not provide advance life support.
Example: tracheal intubation

Life-threatening situation

If the situation is life-threatening (e.g. non-responsive, cyanotic, absence of pulse, etc.), nursing staff must do the following:

Stage	Description
1	Implement Cardiopulmonary Resuscitation (CPR) using a non-rebreathing resuscitation mask.
2	Page a Code Blue (Ext. 2633). The operator pages the on-call attending of the week. The following persons respond to the Code Blue: Unit resident and attending - must also be paged On-call attending of the week (must notify the Medical Director in advance if unable/unavailable to perform this duty during any specific timeframe of the work day) The on-call resident is the only physician available to respond during the "off" hours
3	Call 911 and direct the ambulance to the side entrance on the corner of W. Leland Anderson and 2800 South MacGregor.
4	Continue implementation of life saving measures to include the following as deemed necessary: Basic life support Cardiopulmonary resuscitation (CPR) Use of automated external defibrillator (AED) Establishment of intravenous line Administration of emergency medication as approved for use by P&T committee Oxygen administration Record process: Nursing staff completes Code Blue/Medical Emergency Documentation Record
5	Nursing staff and MD ensure completion of the Memorandum of Transfer (MOT) form Nursing or Case Management notifies family/significant other of the individual's transfer and documents on MOT. Further attempts to notify are put in the progress note after the individual's transfer.
6	Nursing staff retains copy of the MOT form and sends to the Nursing Supervisor with the shift report.

Non life-threatening situation

A non life-threatening situation is not of Code Blue severity, and may include psychiatric emergencies. Staff proceed as follows:

Documentation

Staff report the medical emergency using one of the following procedures, as applicable:

Occurrence Reporting Process

Patient Care Variance Reporting Process

Security duties

Security/designee meets the ambulance and accompanies emergency personnel to the unit.

Evaluation process

The Nursing Supervisor, manager, or designee:

Completes the Code Blue Evaluation form

Forwards the completed form to Nursing Administration who forwards it to the Safety Committee

Further questions

If a staff member has further questions regarding medical emergencies, s/he should contact her/his supervisor.

Related standard

The Joint Commission : Provision of Care

If you have questions regarding the content of this site please contact the Policy and Procedure Committee. If you experience any technical problems please contact the MIS Department.