Comparison of Code Blue Practices Between the First Year of COVID-19 and the Previous Year

Aim: After the coronavirus disease-2019 (COVID-19) infection was declared a pandemic, there were some changes made to the code blue and resuscitation practices. We compared code blue practices between the first year of COVID-19 and the previous year. Methods: We accepted the pre-pandemic (group 1) period from March 11(th), 2019 to March 11(th), 2020, and the post-pandemic (group 2) period from March 11(th), 2020 to March 11(th), 2021. The study was designed as a cross-sectional study. We investigated the incidence of code blue, the unit where the call was made, the team's time of arrival, the return of spontaneous circulation (ROSC), the duration of cardiopulmonary resuscitation, and the general outcomes. We analyzed the 6 month follow-ups of the patients. Results: There was an increase in the incidence of code blue in group 2 (0.4-0.9%). The two groups showed a significant difference in the time of arrival, ROSC, and 1 month and 6 month survival. The ROSC rate and 1 month survival were lower in COVID-19 patients (p < 0.001). Six month survival was lower in COVID-19 patients (p=0.031). We identified 63 faulty calls, and 38 of these patients died within 6 months. Conclusion: The faulty code blue calls may be a predictor of poor prognosis, and early warning systems should be developed for patients with poor conditions.

Automated summary

After the COVID-19 pandemic, there have been changes in code blue practices. This study compared the code blue practices between the first year of COVID-19 and the previous year. The results showed an increase in the incidence of code blue in the COVID-19 period, and there were significant differences in arrival time, return of spontaneous circulation (ROSC), and survival rates. Faulty code blue calls may predict poor prognosis, highlighting the need for early warning systems for patients in critical condition.