>> Good morning, Mr. Smith--
my name is Tammy. I'll be your
nurse today. Mr. Smith?
Mr. Smith? I need help
in room eight! >> What's going on, Tammy?
What do you need? >> I can't find a pulse
and he's not breathing. He's a full code-- call code.
>> Call a code? Someone call a code blue
in room eight! >> (over intercom)
Code blue, room eight, code blue, room eight.
>> Tammy, I'm gonna stop your antibiotic... and make sure some normal
saline is infusing here. >> Can we put this
board underneath him? >> Yes. >> And I'll grab
the bagger. >> I'll scribe on the
code blue record. (oxygen flowing) >> Tammy, I'm not getting a
good feel-- can you help me? >> Yeah, you want
to do two person? >> Yeah-- if you take the mask,
I'll take the bag. >> It's right here! >> Better seal?
>> I think that's better. >> All right, we're
with the code team. I'm gonna put
the pads on. >> I can take over bag.
>> Oh, good. >> Tammy, I'll go
get the chart. >> Get that one on. >> Okay. >> I'm Dr. Sellinger--
I will be the code captain. Let's stop compressions
for a second, please, and let's see what kind
of rhythm we have. >> It looks like defib. >> Okay, let's defibrillate
at 150 joules and we'll change compressors
following, please. (high tone sounding)
>> I'm clear, you're clear,
everybody's clear, oxygen clear. Shock delivered. I defibrillated
at 150 joules. >> Okay, let's
resume compressions and administer epinephrine
1 milligram IV push. Who's scribing? >> I am-- my name is Denise.
>> Okay, Denise, if you can let me know when
two minutes have passed, please. >> There's your swab. Here's a swab. >> Got good IV access?
>> Yep, site looks good. >> (quietly counting). >> Here's a swab. >> Epi, 1 milligram
IV in. >> Okay, can someone tell me
what happened here, please. >> Yeah, we have
here a Mr. Smith. He's a 37-year-old man. He came in with pancreatitis
a couple of days ago. He does not have
any allergies. He's diabetic-- his sugars
have been running a bit high. He's febrile
this morning. His last vital signs--
pressure was 94/48, pulse was 104,
respirs was 28. He is on
antibiotics. I came in this morning
to do his assessment and found him
unresponsive. He has a full code
according to his vitals. >> Okay, let's administer
500 mls of normal saline, run that wide open, and if we can prepare
for the administration of 300 milligrams of
amiodarone IV push, please. >> Okay.
>> Okay, that bolus is running. >> Okay, do we have a good pulse
with compressions as well? >> Good pulse with
compressions. >> Okay, can someone get
a hold of the family and inform the attending
physician as well for me, please? >> I'm from social work--
I'll call the family. >> I'll get a call
into the attending. >> It's been two minutes
since the last shock. >> Okay, let's stop compressions
and reassess the rhythm, please. >> It looks like defib. >> Okay, let's
defibrillate 150 joules and we'll change compressors
following, please. >> Okay, charging. I'm clear, you're clear,
everybody's clear, oxygen clear. Shock delivered.
>> Let's resume compressions. >> Sorry, was that cardioversion
or defibrillation? >> It was defibrillation
at 150 joules. >> Okay, let's give amiodarone
300 milligrams IV push, and could we get a
glucose, please? >> Yeah, I'll go
get the glucometer. >> Okay, it's in. >> Sorry, I just didn't get the
name of that drug you just gave. >> Amiodarone,
300 milligrams IV push. >> I'm having some
difficulty bagging. >> Okay, let's go
ahead and intubate. Can I get a pair of
safety glasses and gloves as well, please? >> All right, I'm going to
want (indistinct) supplies, so can I have a laryngoscope
handle with a three blade, a number eight endotracheal
tube with a stylet, syringe, the
CO2 detector, tool ties, and
procedure mask. >> Okay, continue
his CPR. Can we prepare to change
compressors, please? Anytime.
>> Thanks. >> Let me take over.
>> (breathless) Thank you. >> Lindsay, can you check to
make sure we have a good pulse with compressions? >> Yup, there's a good
pulse with compressions. >> IV is running well? >> I'm gonna
check the cuff. >> Yep, that pulse
is going good. >> Okay, cuff is good. >> Let's go ahead
and intubate. >> Okay, I'm just gonna
auscultate the chest one more time here,
just to listen. Continue with
compressions. Okay, we've got good
air entry bilateral. What's our
oxygen saturation? >> I don't have a sat
monitor on right now. >> Okay, we'll get
a sat, right away. >> Okay.
>> We have a number eight
endotracheal tube and it is at 24
at the lip. >> Here's the glucometer.
>> Thank you. >> Could we also get a
sat monitor as well so we can monitor
the SpO2? >> Yeah, I'll go find one.
>> Okay, thank you. >> Glucose is 3.1. >> Okay, let's give an amp
of D50, please, IV push. >> (indistinct speaking). >> Okay, how long has it been
since our last epinephrine? >> It's been
five minutes. >> Okay, let's prepare and then
administer another milligram-- 1 milligram of
epinephrine IV push, please. >> Dextrose 50%--
1 amp is in. >> Here's our sat monitor. Here's another swab. Sats are at 99%.
>> 99%, okay. How is bagging?
>> It's good. >> Epi, 1 milligram is in. Can you pass me
a flusher, June? >> Yep. >> Okay, let's
stop compressions and reassess the
rhythm, please. >> Okay, it looks like a
normal sinus rhythm now. >> Okay, if we could
check the pulse and let's do a blood
pressure, please. >> Okay, we
have a pulse. >> Blood pressure
is 88/40. >> Okay, great. Let's continue with
normal saline at 250 mls
an hour. Let's do a stat chest x-ray,
ECG, and CCU bloodwork. We will arrange a bed in ICU,
and great work, everyone. Good job. >> Is the code over?
>> Yes, the code is over. >> I'll document it at 9:07,
and I'll just need everybody to stick around and verify and
sign the code blue record. >> Okay.
>> Okay. Let me have a
look there. >> Okay, two a piece,
two shocks-- okay, looks good
from my perspective. Lindsay, have a look. >> (mumbling). That looks right. >> Thank you. >> Okay. >> Can you squeeze
the bag for a second? >> For sure, yup. >> Oh, I see that you missed
the endotracheal tube. So, it was a number eight
at 24 at the lip. >> Okay. >> I just spoke to the
intensive care unit and they are ready to transport
the patient to ICU. >> Great-- I'll come down
to ICU and give report. >> Okay. >> Before we go, I'm gonna just
print a strip in sinus rhythm and then post it in
the code blue record. >> Okay, so I'm just
verifying the time. There's a time difference
of 10 minutes and I will record
that on the strip. >> Okay, great,
thank you.
