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Practice English Speaking&Listening with: Code Blue

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>> 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.

The Description of Code Blue