The Effect of Mock Code Blue Simulations and Dedicated Advanced Cardiac Life Support Didactics on Resident Perceived Competency

Abstract

In-hospital cardiac or pulmonary arrest is associated with high mortality. In the USA, approximately 200,000 of these events occur and are associated with overall survival rates of 18%-20%. Despite advances in resuscitative methods, the probability of intact survival also remains unfavorable. Though many factors play a role, we believe a large portion of a patient's survival is dependent on the competency of the leader of the code blue or resuscitative team's efforts. Newly minted physicians who enter medical training in their respective residencies are equipped with a wide range of clinical competency in regards to hands-on experience and aptitude with handling code blue scenarios. Through the use of mock code blue simulations along with dedicated didactics over a seven-month time span, we were able to demonstrate success in improving clinical competency and patient survival outcomes.

Keywords: cardiac resuscitation; code blue; critical care; internal medicine; medical residency; pulmonary critical care; quality improvement research; simulation medicine.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, Ngo et al.

Figures

Figure 1. Survey question 1

I am confident in my abilities and I am comfortable in running a code without an attending physician

Figure 2. Survey question 2

I have a clear understanding of my role during a code blue

Figure 3. Survey question 3

I feel comfortable announcing my role and communicating it with the resuscitation team during a crisis

Figure 4. Survey question 4

I feel comfortable assessing the effectiveness of chest compressions

Figure 5. Survey question 5

I feel comfortable drawing up resuscitation medications during a code blue scenario

Figure 6. Survey question 6

I feel comfortable operating the defibrillator during a code blue

Figure 7. Survey question 7

The use of mock code blue drills will play an important role in preparing me to handle crisis situations in the future

Figure 8. Survey question 8

Practicing multi-disciplinary, team-based mock code blue scenarios at DRMC would make me more comfortable in code blue situations in the future DRMC: Desert Regional Medical Center

Figure 9. Survey question 9

Practicing multi-disciplinary, team-based mock code blue scenarios will improve patient outcome

Figure 10. Survey question 10

Code blue and crisis management training should be mandatory for all residents at DRMC DRMC: Desert Regional Medical Center

Figure 11. Survey question 11

Team debriefing after a code blue or crisis scenario is important

Figure 12. Survey question 12

I would like to participate more in simulated crisis scenarios and mock codes and believe that they should be held more frequently

Figure 13. Length of resuscitation efforts

Figure 14. Reason resuscitation efforts ended

Figure 15. Hospital discharge status after cardiac arrest