CODE NURSE

DEFINITION:
A registered nurse who is responsible, alert in rendering nursing care patients undergoing
cardiac arrest. Participates in the general activities involved in the care of the patients especially
diagnostic, therapeutic and palliative measures.

QUALIFICATIONS AND REQUIRMENTS:

1. Should be a graduate from a College of Nursing of recognized standing and must be a

Bachelor of Science in nursing degree holder.
2. Should be a registered nurse in the Philippines.
3. Should be able to communicate effectively and develop rapport with patients and co-
workers.
4. Should be mature honest and quick in decision-making.
5. Evidence of good moral and physical health.
6. Should have at least 2 years experience in medical, surgical, OB/GYN, pediatric wards.

NURSING RESPONSIBILITIES:

A. Prepares all equipment needed for emergency resuscitation, assist the physician in
intubation of patients.

• Inserts mouth guard or oral airway into the patient’s mouth to open and start ventilating
patient, ambubag should be connected to an oxygen set up and regulate oxygen flow to 6-
8 liters per minute. Check for the presence of suction apparatus. If none, have staff nurse
secure one ASAP. Delegates one staff to ventilate patient while preparing other things
needed for the code.
• Prepares at once the functioning laryngoscope, endotracheal tube, wire guide, KY jelly
and mouth guard. Check ET balloon by inflating it with an empty disposable syringe
before handling it out to the physician.
• Attaches 3 electrodes to patients chest: one-below right clavicle hollow area: two-below
left clavicle hollow area, three-below last rib left midclavicular area/line. Connect these
electrodes to the monitoring defibrillator. Defibrillator jelly must be in view for use with
defibrillator.

B. Prepares and assist in IV fluid infusions, giving of emergency medications, etc.

• Starts IV lines if not available.

• Starts preparing emergency medications needed.
• Records in the code pink sheet the patients data, all medicines and IV’s used,
defibrillation done if any, procedures done, time started and time ended, result of the
code, signature of the AP, resident physician in charge, or Senior Resident attending the
code. This code is attached to patient’s chart or ER record in DOA cases.
C. CHARGING
• Charges all IV fluids, medications and catheters used during code and replaces with
stocks taken from central service and pharmacy department. These respective areas will
do the charging.
• Code nurses charges the following:
• Announced code
• Silent code
• Use of monitor/defibrillator
• Oral airway (adult/pedia)

D. Towards Supplies and Equipment and E-cart:

• Makes inventory of equipment and supplies every shift preferably at the start of the shift.
• Checks equipment if functioning (ambubag, laryngoscope. cardiac monitors).
Communicate with the supervisor/head nurse for ay problems
• Responsible for the cleanliness and orderliness of equipment, supplies in the emergency
carts.
• Checks expiration date of medicines, supplies in the E-carts.
• Submits monthly inventory of medicines, equipments and supplies.
• Cleans and washes used ambubags and dries all parts,

E. Other Responsibilities:
• Performs ECG to patients when the Cardiopulmonary section technician is off.
• Assist in the other nursing units especially those with critical patients, if the above
mentioned areas are not busy.
• Makes rounds on critical patients to anticipate their needs.

F. Recording
• Writes down all endorsements on the record book of the following:
• Condition of all patients resuscitated, critical patients within the shift and endorse for
follow-up.
• Patients whose ECG’s were taken during 9pm-7am.
• Location of ambubag placed at patient’s bedside.
Submits a written report of all CODE 99, CODE 88 AND Silent Code every end of the
month to the MEDICAL RECORDS.