The reasons and the rightness of cod blue emergency calls in our hospital

Code Blue is designed for emergency cardiac arrest events of the big hospitals in Turkey and all over the world, which will be predicted or are impossible to predict. It is a combination of a correct intervention to the correct patient at a correct time, a good organization and training. Recent resuscitation development attempts concentrate on pre-arrest period for this reason. The primary object of the study is to evaluate the reasons and the accuracy of the reason of a code announcement for the patients for whom Code Blue is called. The secondary object is to evaluate the mortality of the interventions performed by Code Blue quick response team to cardiopulmonary arrests and to detect the ratio for staying in the intensive care unit after intervention, releasing from the hospital and exitus. 761 patients who were called for Code Blue were enrolled in the study with an approval of Başkent University Clinical Research and Ethics Committee (the project with no. KA 14/267). The study was prepared retrospectively. When general demographic data of the patients were examined it was seen that mean age was 65,14±20,42 and age of the youngest patient was 1 year whereas age of the oldest patient was 100 years in age distribution. It was recorded that 421 of patients were male whereas 340 of patients were female. The patients were divided into two groups as those who were called for the correct Code Blue announcement (n=691) and those who were called for the wrong Code Blue announcement (n=70) according to their records in correct or wrong announcement sections of KPR forms. Wrong code ratio was found to be 9,2%. In the demographic data of both groups, mean age of the group for whom a correct code announcement was made was found to be 65,8±20,5 whereas mean age of the group for whom a wrong code announcement was made was found to be 58,6±18,8, and this difference was statistically significant with a p value of 0,005. When the reason for applying to the hospital was investigated the wrong code was found higher compared to the correct code in the patients hospitalized due to genitourinary system diseases, most of which was CDF patients and in the patients followed-up due to malignancy. Among the patients applied to emergency service, the highest number as a reson for correct code announcement was seen in the records of the patients who presented with loss of consciousness to the emergency department. It was seen that number of patients considered as the correct announcement was 21 whereas number of patients considered as wrong announcement was 11. This number was recorded as the highest wrong announcement ratio among the reasons of code announcements. When all the wrong codes were evaluated, syncope and changes in the state of consciousness was in the first two places numerically. In our study, ratio of wrong code announcement was found to be 9,2% (n=70). Ratio of the patients who died at the end of the intervention was recorded as 27,5% (n=209). Death rate after acceptance in intensive care unit was recorded as 69,5% (n=306). Ratio of the patients who were released from the hospital was found to be 29,3% (n=129). In conclusion, the group of the patients with multiple chronic diseases represent the majority of correct code announcements among the reasons of Code Blue announcements. This result is an expected outcome as our critical patient population is high as a University Hospital. A high rate of wrong code was observed due to anxieties of the patients who were followed-up for malignancy and their relatives. The fact that code was also called for the patients who were stably followed-up in the patients having seizures was detected as the cause of high wrong code ratio. It is emphasized that nurse administration should organize regular training programs for preparing and filling CPR forms and more accurate documentation should be provided for further studies.