Code Blue Response Documentation Checklist
Document comprehensive code blue/cardiac arrest response including CPR quality, defibrillation, medications, and team performance for quality improvement.
- Industry: Healthcare
- Frequency: Every code blue event
- Estimated Time: Post-event documentation
- Role: Code Team
- Total Items: 27
- Compliance: AHA ACLS Guidelines, Joint Commission Resuscitation Standards, Get With The Guidelines
Initial Response
First responder actions
- Unresponsiveness verified?
- Code called immediately?
- CPR started within 2 minutes?
- AED/defibrillator retrieved?
CPR Quality
High-quality CPR metrics
- Compression depth adequate (2-2.4 inches)?
- Compression rate 100-120/min?
- Full chest recoil allowed?
- Minimal interruptions (<10 sec)?
- Compressors rotated every 2 minutes?
Airway & Breathing
Airway management
- Airway opened (head-tilt/jaw thrust)?
- Bag-valve-mask ventilation effective?
- Advanced airway placed?
- Type of advanced airway
- End-tidal CO2 monitored?
Defibrillation
Shock delivery
- Initial rhythm analyzed?
- Initial rhythm
- Shockable rhythm present?
- Number of shocks delivered
- Shocks delivered with minimal pause?
Medications Administered
ACLS medications
- IV/IO access obtained?
- Epinephrine given per protocol?
- Amiodarone given (if VF/pVT)?
- Other medications documented?
Code Outcome
Final outcome
- ROSC achieved?
- Time to ROSC (if applicable)
- Code terminated time
- Family notified?
Related Healthcare Checklists
- Hand Hygiene Compliance
- Medication Safety Check
- Surgical Safety Checklist
- Fall Prevention Assessment
- Joint Commission Readiness
- HIPAA Compliance Audit