​Strengthened processes ensure more rapid and effective resuscitation for patients who go into cardiac or respiratory arrest. By Dr Chew Si Yuan, Senior Resident, Dept of Respiratory and Critical Care Medicine

When a patient on Campus is found to be not breathing, or when the heart stops beating, Code Blue is activated immediately. It is critical that resuscitation is initiated early as the patient’s chance of survival and disability-free recovery falls with every minute of delay. In order to ensure that patients receive rapid resuscitation within 5 minutes of activation, a well-coordinated and well-oiled resuscitation team response is key. 

The following enhanced measures help to ensure the speed and quality of the SGH Campus Code Blue response:

1. Code Blue is activated even if primary care team is already present

Co-management by the Code Blue team and primary care team will result in a more rapid and effective resuscitation effort.

2. Multidisciplinary team 

The Code Blue team comprises doctors, nurses and respiratory therapists selected for their clinical expertise with critically-ill patients and experience in managing the ABCs (Airway, Breathing, Circulation) of a cardiopulmonary arrest.

3. Rigorous and frequent training

Teams undergo regular training together, conducted in simulation labs or in-situ on high-fidelity mannikins. A wide variety of cardiopulmonary arrest scenarios is simulated, with emphasis on management of the airway, breathing and circulatory systems. By training together, team members become familiar with each other’s roles and are able to anticipate tasks without prompting – this makes for a more rapid and effective resuscitation effort. 

Team members undergo regular simulation training together so that they can function like a well-oiled Formula 1 pit-stop crew to deliver life-saving interventions rapidly.

4. Location-based coverage

Code Blue teams are deployed according to a location-based coverage system so as to minimise movement time. Teams assigned to a certain location typically consist of healthcare staff based in the vicinity. They will attend to all patients within the assigned location regardless of discipline. 

For example, a surgical patient admitted to a Block 4 ward can be attended to more expediently by the Block 4 Code Blue team, made up of a doctor, nurse and respiratory therapist that are based in the CCU and MICU located at Block 4. 

5. Advanced equipment

Code Blue teams come equipped with advanced resuscitation equipment such as intra-osseous devices, laryngeal mask airways and video-laryngoscopes.

To find out what you need to do during a Code Blue, view slides here.

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