Improvement of the functioning and efficiency of a Code Blue system after training in a children's hospital in China

Yu Shi; Gongbao Liu; Di Cao; Guoping Lu; Lin Yuan; Yuping Qian; Jie Xu; Chengjun Sun; Mengmeng Ge; Lingyu Lai; Xuan Wang; Yiqun Lu; Guoying Huang; Xiaowen Zhai

doi:10.21037/tp-20-171

Improvement of the functioning and efficiency of a Code Blue system after training in a children's hospital in China

Transl Pediatr. 2021 Feb;10(2):236-243. doi: 10.21037/tp-20-171.

Authors

Yu Shi¹, Gongbao Liu¹, Di Cao¹, Guoping Lu², Lin Yuan³, Yuping Qian³, Jie Xu³, Chengjun Sun⁴, Mengmeng Ge⁵, Lingyu Lai⁶, Xuan Wang⁷, Yiqun Lu⁸, Guoying Huang⁹, Xiaowen Zhai¹⁰

Affiliations

¹ Division of Medical Administration, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
² Intensive Care Unit, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
³ President's Office, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁴ Department of Endocrinology and Inborn Metabolic Diseases, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁵ Department of Neonatology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁶ Department of General Medicine, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁷ Department of Anesthesiology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁸ Department of Urology Surgery, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
⁹ Cardiovascular Center, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.
¹⁰ Department of Hematology/Oncology, National Children's Medical Center Children's Hospital of Fudan University, Shanghai, China.

Abstract

Background: Code Blue is a popular hospital emergency code that is used to alert the emergency response team to any medical emergency requiring critical care. By retrospectively studying Code Blue cases in a children's hospital, we looked for high-risk factors associated with survival and how to improve the effectiveness of Code Blue systems through training.

Methods: Data were collected on age, gender, department, diagnosis, time of Code Blue call activation, time between call and arrival of the Code Blue team, treatment details and outcome before and after the training process from January 2016 to December 2019. Chi-square test and logistic regression analysis were used to analyze the data.

Results: A total of 139 Code Blue cases from the period of January 2016 to December 2019 were retrospectively studied. The wards where Code Blues occurred most frequently were the infectious diseases ward (n=31, 22.3%), the hematology and oncology ward (n=30, 21.6%), and the cardiology ward (n=15, 10.8%). Age, inpatient status, time of arrival, the time of cardiopulmonary resuscitation (CPR), and the cause of shock were all risk factors for death. After the training, the arrival time and recovery time were significantly reduced (P<0.01). The proportion of patients who were transferred to the ICU had increased (P<0.05), and the proportion of deaths had decreased (P<0.01). The survival curve improved (P<0.05).

Conclusions: It is very important to summarize the risk factors related to Code Blue. It is clear that the efficacy of the Code Blue events improved after training of the hospital staff in the Children's Hospital.

Keywords: Code blue; children’s hospital; survival curve.