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201606179

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Policies,Clinical,UWHC Clinical,Department Specific,Surgical Services,Clinical

Cardiac Arrest Protocol (2.05)

Cardiac Arrest Protocol (2.05) - Policies, Clinical, UWHC Clinical, Department Specific, Surgical Services, Clinical

2.05

UNIVERSITY OF WISCONSIN

POLICY & PROCEDURE

EFFECTIVE DATE

1978
ORIGINAL
 REVISION

APRIL 2016
PAGE 1
OF 2
POLICY #

2.05
ADMINISTRATIVE MANUAL
NURSING MANUAL
OTHER Surgical Services
CSC and AFCH
TITLE
CARDIAC ARREST PROTOCOL


I. PURPOSE

To establish a standard procedure to be followed during an arrest in Surgical Services.

II. POLICY

A. Arrest will be declared by the anesthesiologist/anesthetist (non-physician provider) or surgeon. The
circulator nurse should ask if she/he should activate the “Emergency Anesthesiology Group Page”
system posted in each operative room (near the telephone). (NOTE: The OR charge nurse/med flight
pager is included in the group page anesthesia receives for notification of O.R. room in emergencies.)
1. Main OR and Outpatient OR: Anesthesia Emergency Procedure
a) Make overhead paging announcement via red phones or announce in O.R. hallway in OSC.
 Example: "Anesthesia to O.R. STAT"
b). If no response to 1 a - Proceed to Emergency "Mass" Page All Anesthesia Faculty
at Once:
 Dial 2-0000.
 When paging answers ask them to "page 9191", or ask them to page the "Emergency
Anesthesiology Group Page".
 Direct them to the location of the emergency: Inpatient O.R. Number / AFCH.
2. AFCH Anesthesia STAT After hours:
a) When do we initiate this: 1700-0700 (weekdays), 0700-0700 (Sat/Sun/Holidays)
b) What number do we call: 2-0000
c) This is what you will be asked:
 What is your Emergency: Anesthesia STAT
 Where is your Location: AFCH OR C____
 Give your name and phone number
d) For a Cardiac event or for more help call: PICU Attending at 219-5653

B. The circulating nurse and/or charge nurse will coordinate activities of the room.
1. Send for code/crash cart.
2. Assign someone to assist Anesthesia if possible.
3. Assign other personnel available to assist as needed.
4. Ask additional people to leave the room if not needed.
5. Notify the charge nurse if an ICU bed is needed.
C. Procedures performed on the patient during the arrest (i.e. trach, cutdown for line placements, etc.)
will be documented in the patient care record.

UNIVERSITY OF WISCONSIN

POLICY & PROCEDURE

EFFECTIVE DATE

1978
ORIGINAL
 REVISION

APRIL 2016
PAGE 2
OF 2
POLICY #

2.05
ADMINISTRATIVE MANUAL
NURSING MANUAL
OTHER Surgical Services
CSC and AFCH
TITLE
CARDIAC ARREST PROTOCOL


D. Anesthesia staff will document medications administered.
E. The circulating nurse or their designee will be responsible for assuring the code/crash cart has been
restocked.

III. REFERENCE

OR Policy and Procedure #2.10 - Documentation for the Care of the Patient in the Operating Room

REVIEWED BY

Surgical Services Policy and Procedure Committee 4/2016
Dr. Chris Turner, Director Perioperative Services 4/2016
Dr. Deb Rusy, Director Perioperative Services – AFCH 4/2016

SIGNED BY

Sandy Schoenmann, BSN, RN
Interim Director, Surgical Services Department



























UNIVERSITY OF WISCONSIN

POLICY & PROCEDURE

EFFECTIVE DATE

1978
ORIGINAL
 REVISION

APRIL 2016
PAGE 3
OF 2
POLICY #

2.05
ADMINISTRATIVE MANUAL
NURSING MANUAL
OTHER Surgical Services
CSC and AFCH
TITLE
CARDIAC ARREST PROTOCOL