Respiratory Arrest

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Category/Organ System:	Category: Cardiovascular Problems (old)
Type:	[[:Category: Medical Problem (old)]][[Category: Medical Problem (old)]]
Main Diagnosis:	Arrest
Sub Diagnosis:	Respiratory Arrest-Witnessed
Diagnosis Code:	10003 -Respiratory Arrest
Comorbid Diagnosis:	No
Charlson Comorbid coding (pre ICD10):	0
Program:	CC & Med
Status:	Currently Collected

Data Integrity Rule -as of 5 June 2000

Never use 100-03 as primary admit diagnosis. Always code the reason for the respiratory arrest first, then code 100-3 only if the following criteria are met:

• A. Code Blue is called
• B. Code Blue record is completed
• C. Pulse is present
• D. Intubation is required

• see: Unwitnessed Cardiac Arrest
• see: Witnessed Cardiac Arrest and Cooling Protocol BRR

Discussion

Template:Discussion I'm not sure the above rules are realistic in terms of code blue records and a code being called.Some patients are intubated on the ward and brought to ICU or intubated immediately on arrival without an actual code being called. I would think they would be coded respiratory arrest regardless of a code call or not.What do the rest of the ICU collectors do?If everyone is sticking to all of the rules I will remove this discussion. Thanks!GHall 22:03, 7 July 2011 (CDT)

• I do code respiratory arrest for some situations that do not fit the above rules. If a "Code 25" or "HMO STAT" is called or the attending MD is seeing the patient on the ward, and the patient requires immediate intubation-I code it as a respiratory arrest. The wards often use their own familiar chart forms/addendums rather than the "Code Blue" record for such events; therefore, I do not stick to the rule " "Code Blue" record is completed".

I do not code respiratory arrest if the patient can "maintain their airway" for transport to ICU or ER for more of a controlled or 'elective intubation' (some sites send patients to ER for stabilization until bed available in ICU).Mlaporte 16:49, 19 July 2011 (CDT)

• • I only call it resp arrest if a code blue sheet is completed. Intubations in the ICU are not considered resp arrest unless a code blue is called as well because it is a controlled environment set up for critical issues like this. A resp arrest is an emergent event and should be treated as such. If intubations occur during a 25 code on the ward, a code blue sheet should be completed ideally by the ICU staff. You could probably argue that one as a resp arrest without the sheet but I think this is rare. This needs to be clarified Trish. --LKolesar 13:07, 20 July 2011 (CDT)

• • • ICU staff do not respond to "Code 25" at some community hospitals. The ER doctor and RT respond. Mlaporte 21:12, 21 July 2011 (CDT)