Code Blue: Respiratory arrest
"And, has thou slain the Jabberwock?
Come to my arms, my beamish boy!
O frabjous day! Callooh! Callay!'
He chortled in his joy.
JABBERWOCKY by Lewis Carroll
1500: An 82 year old female with pneumonia and exacerbation of COPD. Monitor alarm heard for heart rate less than 50. Patient found unresponsive with agonal breathing. Rapid response called. Positive pressure ventilations given to the patient. No improvement in patient with ventilations. Unable to obtain pulse. Code Blue called.
1506: Epinephrine 1mg IV given. CPR in progress with positive pressure ventilations.
1508: Rhythm check. No pulse detected.
1508: CPR in progress. Difficult to ventilate. Abdomen very distended. Nasogastric tube inserted and stomach decompressed. Ventilations improved.
1510: Vasopressin 40 units given. CPR in progress. Ventilations adequate. Intubation deferred.
1513: Epinephrine 1mg IV given. CPR in progress. Noted to have crepitation over the sternum with compressions. Suspect fracture.
1515: Rhythm check performed: sinus tachycardia. Strong radial and femoral pulses present.
1517: Continuing oxygenation with positive pressure ventilations.
1519: Change in rhythm. Pulse detectable at this time. Continuing ventilations.
1520: Patient becoming more difficult to ventilated. Noted to have subcutaneous emphysema over the lower neck.
1521: Unable to obtain pulse. CPR restarted. Patient intubtated with 7.0 oral ET tube with positive end tidal CO2. Asymmetrical chest rise on the right with decreased breath sounds noted. CXR done. Epinephrine 1mg IV given.
1525: CXR show right pneumothorax. ET tube placement adequate. Needle decompression performed 2nd intercoastal space right midclavicular line. Immediate improvement in ventilations. CPR continues. Rhythm check. Right side chest tube inserted.
1527. Strong femoral pulse present. Oxygenations adequate. Saturations 95%. Patient becoming more responsive. Respirations more spontaneous.
1530. Pulses and oxygenations remain good. Patient more alert. Placed on ventilator.
1535. Pulses and oxygenation remain good.
1545: Transferred to ICU.
Come to my arms, my beamish boy!
O frabjous day! Callooh! Callay!'
He chortled in his joy.
JABBERWOCKY by Lewis Carroll
1500: An 82 year old female with pneumonia and exacerbation of COPD. Monitor alarm heard for heart rate less than 50. Patient found unresponsive with agonal breathing. Rapid response called. Positive pressure ventilations given to the patient. No improvement in patient with ventilations. Unable to obtain pulse. Code Blue called.
 |
| CPR rhythm |
 |
| CPR rhythm |
1508: Rhythm check. No pulse detected.
 |
| PEA rhythm |
 |
| CPR rhythm |
1510: Vasopressin 40 units given. CPR in progress. Ventilations adequate. Intubation deferred.
 |
| PEA rhythm |
1513: Epinephrine 1mg IV given. CPR in progress. Noted to have crepitation over the sternum with compressions. Suspect fracture.
 |
| PEA rhythm |
1515: Rhythm check performed: sinus tachycardia. Strong radial and femoral pulses present.
1517: Continuing oxygenation with positive pressure ventilations.
 |
| Sinus tachycardia |
1519: Change in rhythm. Pulse detectable at this time. Continuing ventilations.
 |
| 2nd degree AV block type II |
1520: Patient becoming more difficult to ventilated. Noted to have subcutaneous emphysema over the lower neck.
 |
| 2nd degree AV block type II |
1521: Unable to obtain pulse. CPR restarted. Patient intubtated with 7.0 oral ET tube with positive end tidal CO2. Asymmetrical chest rise on the right with decreased breath sounds noted. CXR done. Epinephrine 1mg IV given.
 |
| CPR rhythm |
1525: CXR show right pneumothorax. ET tube placement adequate. Needle decompression performed 2nd intercoastal space right midclavicular line. Immediate improvement in ventilations. CPR continues. Rhythm check. Right side chest tube inserted.
 |
| Sinus tachycardia |
1527. Strong femoral pulse present. Oxygenations adequate. Saturations 95%. Patient becoming more responsive. Respirations more spontaneous.
 |
| Sinus tachycardia |
1530. Pulses and oxygenations remain good. Patient more alert. Placed on ventilator.
 |
| Sinus tachycardia |
1535. Pulses and oxygenation remain good.
 |
| Sinus tachycardia |
1545: Transferred to ICU.
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