On 31 July 2020, we moved to a higher level of PPE requirements for our healthcare workers attending Code Blues and MET calls. All patients who deteriorate and require a Code Blue or MET response will be managed as if they are COVID-19 positive – regardless of their known COVID-19 status or setting of care.
Key change: CPR (chest compressions and bag and mask ventilation) must be conducted in Tier 3 PPE.
Please note further detail on the Code Blue and MET call PPE requirements. Site-specific details can be found here.
- The first responders, will apply Hudson Mask O2 10 L/min on the patient if in cardiac arrest.
- First responders apply Tier 3 and commence compression-only CPR and apply defibrillator and deliver shock if indicated as per Monash Health guideline.
- If another first responder is available, they must don Tier 3 PPE and may commence bag and mask while they wait for the arrest team to arrive.
- While undertaking bag-valve mask ventilation, first responders must ensure they use two-handed vice grip, straight arms, minimise breaths, maintain seal.
- Code Blue and MET teams will don Tier 3 PPE before entering the room.
- All airway management must be performed by the most skilled clinician available during the response.
- Viral filters must be applied to all airway devices at the patient end.
- Intubation or placement of a supraglottic airway: performed by senior critical care staff (Anaesthetics, Emergency & ICU registrars and consultants) trained in the principles of intubating COVID patients or by MICA.
- Anaesthetic SRMOs can attempt placement of a supraglottic airway, if they have been trained in the principles of airway management in COVID patients.
Approved by Prof Carlos Scheinkestel and Dr Anjali Dhulia