Kocaeli Med J. 2025; 14(2): 114-119 | DOI: 10.5505/ktd.2025.17802

Evaluation of Code Blue Practices in Our Hospital: Retrospective Study

Ahmet Ergün¹, Tülay Çardaközü², Nur Nazire Yucal³, Dilek Özdamar², Alparslan Kuþ^2
1Kocaeli City Hospital, Department of Anesthesiology and Reanimation, Kocaeli, Turkiye
²Kocaeli University, Department of Anesthesiology and Reanimation, Kocaeli, Turkiye.
³Basaksehir Cam and Sakura City Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkiye.

INTRODUCTION: In our study, we aimed to evaluate the Code Blue (CB) call system implemented in our hospital, to determine our cardiopulmonary resuscitation (CPR) success rate, problems, deficiencies and mistakes in CB implementation.
METHODS: A retrospective review of CB notifications and hospital records was conducted for patients over 18 who received CB outside the ICU, emergency department, and operating theatre between 2013 and 2021. If cardiopulmonary arrest (CPA) was absent when the team arrived at the CB location, it was defined as a false code blue (FCB). Patient age, gender, CB unit and time, CB team response time, FCB reason, whether CPR was initiated, CPR response, and ICU prognosis were recorded.
RESULTS: 389 (37%) of the 1051 calls given a CB were FCB notifications, the most common reason for FCB notifications is hypoxia findings in the patient (36%). Among the patients who underwent CPR, 62.3% were male and 37.6% were female and the median age was 67 years (IQR: 59-77). The average arrival time of the CB team is 2.77±1.59 minutes. The highest number of CB notifications were received from internal medicine services (22%). 53.7% of CB notifications were made during off-hours. The most common comorbidity in patients with CPA is malignancy (31.4%). In 244 of 662 (36.9%) patients with CPA, CPR was not started until the CB team arrived. Of the 662 patients who underwent CPR, 284 (%42.9) patients died.
DISCUSSION AND CONCLUSION: Since the FCB rate was 37%, we believe training aligned with updated resuscitation guidelines will reduce it and enhance healthcare professionals' awareness.

Keywords: code blue, cardiopulmonary resuscitation, cardiopulmonary arrest

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Hastanemizdeki Mavi Kod Uygulamalarýnýn Deðerlendirilmesi: Retrospektif Çalýþma

Ahmet Ergün¹, Tülay Çardaközü², Nur Nazire Yucal³, Dilek Özdamar², Alparslan Kuþ^2
1Kocaeli Þehir Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Kocaeli,Türkiye.
²Kocaeli Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Kliniði, Kocaeli, Türkiye.
³Baþakþehir Çam ve Sakura Þehir Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Ýstanbul, Türkiye.

GÝRÝÞ ve AMAÇ: Çalýþmamýzda hastanemizde uygulanmakta olan Mavi Kod (MK) çaðrý sistemini deðerlendirmeyi, kardiyopulmoner resüsitasyon (KPR) baþarý oranýmýzý, MK uygulamasýndaki sorunlarý, eksiklik ve yanlýþlarýmýzý tespit etmeyi amaçladýk.
YÖNTEM ve GEREÇLER: 2013-2021 yýllarý arasýndaki yoðun bakým ünitesi, acil servis ve ameliyathane dýþýnda MK verilen 18 yaþ üstü hastalara ait MK bildirim formu ve hastanemiz veri tabaný retrospektif taranarak yapýldý. MK verilen alana ekip ulaþtýðý zaman kardiyopulmoner arrest (KPA) durumu mevcut deðil ise ‘hatalý mavi kod (HMK)’ olarak tanýmlandý. Hastalarýn yaþ ve cinsiyetleri, MK verilen birim ve saat, MK ekibinin alana ulaþma süresi, HMK ise nedeni, KPR’ye baþlanýp baþlanmadýðý, KPR’ye yanýt durumu ve yoðun bakým seyirleri kaydedildi.
BULGULAR: MK verilen 1051 çaðrýnýn 389’u (%37) HMK bildirimidir, HMK bildirimlerinde en sýk neden hastada hipoksi bulgularýdýr (%36). KPR uygulanan hastalarýn %62,3’ü erkek, %37,6’sý kadýndýr, median yaþ 67 yýl (59-77) olarak saptanmýþtýr. MK ekibinin ortalama varýþ süresi 2,77±1,59 dakikadýr. En fazla MK bildirimi dahiliye servislerinden (%22) verilmiþtir. MK bildirimlerinin %53,7’si mesai dýþý saatlerde yapýlmýþtýr. KPA geliþen hastalarda en sýk komorbidite malignitedir (%31,4). KPA geliþen 662 hastanýn 244’ünde (%36,9) MK ekibi gelene kadar KPR’ye baþlanmadýðý saptanmýþtýr. KPR uygulanan 662 hastanýn 284’ü (%42,9) exitus olmuþtur.
TARTIÞMA ve SONUÇ: Çalýþmamýzda HMK oranýnýn %37 olmasý nedeniyle sürekli güncellenen resüsitasyon kýlavuzlarýna uygun eðitimin; HMK oranlarýný azaltacaðýna ve saðlýk çalýþanlarýnýn farkýndalýðýný arttýracaðýna inanýyoruz.

Anahtar Kelimeler: mavi kod, kardiyopulmoner resüsitasyon, kardiyopulmoner arrest

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