MCD00130 Adult and Pediatric Co. AHA GWTG-R ADULT AND PEDIATRIC CODE BLUE DOCUMENTATION FORM Page___of___ PATIENT IDENTIFICATION. Recorder. Signature. …

CODE BLUE NOTES: Document all interventions (e.g. shocks, O2, hand ventilation, line placement, medications, procedures, labs/tests), patient assessments and response to …

Condition of patient when discovered (Check Yes or No where appropriate.)

The purpose of the Code Blue Form is to provide a standardized method for documenting emergency response during a patient's critical situation. This form helps ensure that all …

The document is a Code Blue Form used in medical emergencies to record critical patient information and resuscitation efforts. It includes sections for patient identification, time of …

This code blue form documents a medical emergency event involving a patient. It records details of the patient, the circumstances leading up to the code activation, the resuscitation measures …

EMERGENCY / CODE BLUE: FORM Date: _______________ Time: ________________ Location: ______________ MR# ________________ Name: __________________ DOB: …