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Simulated Protected Code Blue. Randy Wax, MD, FRCPC Rod MacDonald, RRT Human Simulation Program, Mount Sinai Hospital/ University of Toronto Peter Brindley, MD, FRCPC Department of Critical Care Medicine, University of Alberta Revised January 16, 2004.
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Simulated Protected Code Blue Randy Wax, MD, FRCPC Rod MacDonald, RRT Human Simulation Program, Mount Sinai Hospital/ University of Toronto Peter Brindley, MD, FRCPC Department of Critical Care Medicine, University of Alberta Revised January 16, 2004
Present basic concepts of biohazard protection during resuscitation and Protected Code Blue protocols
Simulated biohazard resuscitation scenarios with post-scenario debriefing
First responder discovers unstable situation Activates Protected Code Blue FIRST RESPONDER
Place HiOx mask with filter onto patient FIRST RESPONDER
Initiate chest compressions if no pulse If First Responder can provide automated or manual defibrillation, check and rhythm and shock if equipment available FIRST RESPONDER
First responders should not perform high risk procedures FIRST RESPONDER
PCB Team dons personal protective equipment and adjunct equipment (PAPR in this simulation) PCB TEAM
PCB Team dons personal protective equipment and adjunct equipment (PAPR in this simulation) PCB TEAM
PCB Team members bring resuscitation equipment into room PCB TEAM
PCB Team members bring resuscitation equipment into room PCB TEAM
First Responder gives report to first PCB Team member entering room then leaves FIRST RESPONDER PCB TEAM
Confirm HiOx mask on patient Attach cardiac monitor, pulse oximeter Check initial rhythm
Rapid sequence intubation by expert intubator Manual bag ventilation with filter and 2-person technique only if absolutely necessary
Confirm ETT placement with disposable CO2 detector, observation Difficult to auscultate with PAPR Note: Should have filter between ETT and CO2 detector!!!
Is PEA present? Consider tension pneumothorax Needle decompression +/- chest tube if suspected
Is PEA present? Consider tension pneumothorax Needle decompression +/- chest tube if suspected
Once patient stabilized, begin plans for transport of patient to ICU (or decontamination of room and staff if patient to remain in room)
PCB Team to leave room and decontaminate when patient stable
Produced By: Human Simulation Program, Division of Critical Care Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada And Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada Dr. Randy Wax Dr. Peter Brindley Rod MacDonald, RRT