Analysis of Code Blue Simulation Video: Adherence to ARC and ANZCOR Guidelines

Running head: Complex Care
COMPLEX CARE- Nursing
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1Complex Care
The given video titled “Code Blue Simulation - Virtual Education and Simulation
Training Centre” is about a hospital code blue scene, involving an unresponsive patient
(Youtube.com, 2018). Described below is the analysis of the video, to identify the actions
performed by the medical professionals, and to what extent do they adhere to the
recommendations of the Australian Resuscitation Council (ARC) and ANZCOR
(resus.org.au, 2018). From the video, it was seen that several errors were made by the present
medical team, which deviated from the ARC and ANZCOR guidelines, which will be
discussed below along with the actions which were taken correctly by. This can help to
understand the best practice of care, as well as understand the National Guidelines on
nursing, especially in reference to the guidelines on the resuscitation of patients.
The video begins with the nurse walking in on an unresponsive patient (at 0:15), in a
hospital room, during a regular nursing visit. The nurse was very prompt to check if the
patient had a pulse and so see if he responded to call or touch (audio and tactile stimuli).
When the nurse understands that that patient has no pulse and is completely unresponsive she
calls for help (0:23), and immediately checks the air passage of the patient, and starts giving
her artificial ventilation (as mouth to mouth resuscitation). The medical team also reaches in
less than 10 seconds, and quickly assesses the situation to understand CPR was required. The
patient was then administered artificial ventilation with air bag (0:40) and pads for
defibrillation was placed (0:59) (youtube.com, 2018).
These actions show a significant deviation from the ARC guideline 2 (managing an
emergency), which recommends that the patient should be placed in a lateral position if the
patient is not breathing, before providing ventilation. Also, the guideline recommends that the
patient should be on a flat surface, for which a board can be placed below the patient, which
was not done in this case (Considine & Nation, 23018). However, the present nurse did take a
very prompt action to call for medical assistance, and at the same time checking the airways

2Complex Care
for obstruction and providing mouth to mouth resuscitation. The prompt actions are
recommended by the ARC guideline 2; as such promptness can greatly improve the survival
changes of the patient. Also, checking the response to the verbal and tactile stimuli was also
an important aspect of the guideline 2, which was followed by the nurse (Sunamak et al.,
2015).
The Guideline 3 (Recognition and First Aid Management of the Unconscious Person)
of the ARC and ANZCOR mentions that the saturation of oxygen in the blood should be
checked when providing ventilation to the patient, which was not done by the medical
professionals in the video (Zideman et al., 2015). At 0:47, the patient was provided
ventilation using an air bag, and by 0:53, it was identified that the patient was in defib, for
which shock is needed. At this stage it was recommended that the patient was given
compressions, which were not commenced till after the first shock was given. The guideline
also suggests that both the patient and the rescuer’s safety should be ensured, for which it is
important for two medical professionals to be present, and the most experienced rescuer
should be present with the patient, all of which was addressed by the medical team (Catangui
et al., 2015).
The team also followed the guideline 4 of the ARC and ANZCOR (Airway), as the
nurses were able to assess the breathing of the patient before giving ventilation. The patient
did not seem to have anything choking the airway, due to which it was not necessary to
follow the Chocking Algorithm (Simpson, 2016). Also the patient was given rescue breathing
on time, which was an effective strategy taken by the present nurse. However there was a
significant deviation from the guideline 2 of the ARC ANZCOR (Breathing), which suggests
that before resuscitation, it is important to assess the breathing of the patient properly, by 1)
looking for movement of the upper abdomen, 2) listening for escape air from nose and 3)
feeling for the movement of air at the nose or mouth (Douglas et al., 2016). It also