Patient Treatment Guidelines

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Code Blue Process

Last update: March 17, 2020


Pre-code preparedness

  • It is imperative that Code Blue is prevented in these patients; mandatory evaluation by the ICU service is required when the patient has an oxygen requirement of 5L/min
  • MICU attending physician will carry the Code Blue pager
  • Anesthesia/CC from SICU will carry Code Blue pager
  • Nighttime intensivist will carry Code Blue pager
  • MED-COM will include COVID for Code Blue on these patients
  • Code team
    • Attending/Night intensivist/SICU-Anesthesia CC
    • Critical care RN/charge nurse
    • Transport nurse
    • Transport respiratory therapist
    • Respiratory supervisor
  • CC Pharmacy and ward pharmacist will be present but not enter room; pharmacy code kits will be prepared and available specifically for COVID patients. May hand medications to MD or RN in PPE prior to room entry.
  • Transportable PAPR for physician and respiratory therapist

Code Blue checklist

  • Floor team/RN identifies arrest - call code blue
  • Code cart and defibrillator is pulled into room as per usual
  • Place surgical mask on patient and start compressions – do not attempt airway or bag-valve mask intubation
  • Code team arrives and dons PPE
  • If daytime, MICU attending and SICU anesthesia/CC attending discuss best airway options and choose operator.
  • Anyone not designated on the code team must leave the room
  • ACLS led by attending or designee
  • High consideration for placement of LMA as temporary airway, otherwise proceed to COVID Intubation Checklist
  • ROSC or death declared


  • ROSC or death declared
  • If ROSC, proceed to COVID ICU Transfer Checklist
  • If death, proceed to handling of COVID+ death patients
  • Appropriate equipment decontamination prior to doffing PPE
  • Doff PPE and perform hand hygiene
  • Medicine resident may serve as the pathway director
  • Full debrief


These documents and content on this website are guidelines during the COVID-19 pandemic. Because new information is released rapidly, these documents can be updated or changed at any time. These documents are in no way to be considered as a standard of care and the content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The information in these documents is provided with no guarantees, accuracy, or timeliness. All content in these documents and website are for informational purposes only and do not constitute the providing of medical advice.