AGH Participant Pre-Course Survey
Name: ____________________________________ Credentials: _________________ Date: ________________
1. According to the Allegheny General Hospital policy, what constitutes a Blue Alert?
____________________________________________________________________________________________________
2. How are Blue Alerts initiated?
a.) By calling extension 1111
b.) By yelling “Blue Alert!”
c.) By paging an MD
d.) By calling extension 2222
3. What is the role of the first responder during a Blue Alert?
a.) Establish an airway and begin chest compressions
c.) Stay with the patient and summon help immediately
b.) Place the patient on the back board
d.) Lower the side rail and head of bed
4. Which of the following conversations exhibit accurate check-back?
a.) Doctor: “Increase the Lasix from 10mg to 20mg.” Nurse: “Okay.” Doctor: “Thanks.”
b.) Doctor: “Please increase the Lasix from 10mg to 20mg for Jane Smith.” Nurse: “Sure, I will increase the Lasix for
Jane Smith.” Doctor: “Thank you.”
c.) Doctor: “Ann, please increase the Lasix from 10mg to 20mg p.o. qam for Jane Smith.” Nurse: “I will increase the
Lasix from 10mg to 20mg p.o. qam for Jane Smith.” Doctor: “Thank you.”
d.) Doctor: “Please increase the Lasix from 10mg to 20mg.” Nurse: “Okay, I will increase the Lasix from 10mg to 20mg.”
Doctor: “Thanks.”
5. Which of the following conversations exhibit accurate call-out?
a.) Doctor: “The patient is intubated, please assess for bilateral breath sounds.” Resident: “I am assessing for bilateral
breath sounds.”
b.) Doctor: “Assess breath sounds.” Resident: “Okay.”
c.) Doctor: “The patient is intubated.” Resident: “The patient is intubated.”
d.) Doctor: “I am currently intubating the patient.” Resident: “I am currently inflating the cuff.”
6. For each RRT personnel listed on the left, please write the letter that corresponds to their key role.
Bedside RN _____
A. Brings House Arrest cart, places leads and monitors cardiac activity, leads the
team if the physician is not present, etc.
ICU RN _____
B. Leads the team, provides medical decision-making along with the
development and implementation of the treatment plan, etc.
Respiratory Therapist _____
C. Activates MET and informs them of patient’s problem, identifies patient with
significant changes and informs the charge nurse, obtains vital signs, etc.
Hospitalist Physician _____
D. Performs line placement and other invasive procedures as needed.
IV Team RN _____
E. Performs patient assessment, provides ventilator support and airway
management as needed, monitors pulse oximetry, etc.
Senior Medicine Resident _____
F. Assesses adequacy of intravenous line, inserts more peripheral IVs as needed
ICU Documentation RN___
G. Documents on the RRT record
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7. Please write the number shown in the diagram below next to the appropriate RRT personnel.
Bedside RN _____
ICU RNs _____ and _____
Respiratory Therapist _____
Hospitalist Physician _____
IV Team RN _____
Senior Medicine Resident _____
ICU Documentation RN_____
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8. For each Code Blue Team personnel listed on the left, please write the letter that corresponds to their
key role.
Bedside RN _____
A. Brings House Arrest cart, places leads and monitors cardiac activity, leads the
team if the physician is not present, documents on emergency response form
all pertinent aspects of the code, etc.
ICU RN _____
B. Leads the team, provides medical decision-making along with the
development and implementation of the treatment plan, etc.
Respiratory Therapist _____
C. Activates Cardiac Arrest Code team and informs them of patient’s problem,
identifies patient with significant changes and informs the charge nurse,
obtains vital signs, documents Cardiac Arrest Code team activation in
patient’s medical record, etc.
MICU Resident _____
D. Performs line placement and other invasive procedures as needed.
Senior Resident on CCU Service _____ E. Performs airway assessment, establishes patient airway, provides ventilator
support, monitors pulse oximetry, documents assessments/interventions, etc.
Surgical Resident _____
F. Assist with code as needed
Anesthesia _____
G. Assist anesthesia as needed, provides ventilatory support and airway
management as needed, monitors pulse oximetry
Medicine Resident on Teaching _____ H. Assist with code as needed
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9. Please write the number shown in the diagram below next to the appropriate Code Blue Team personnel.
Bedside RN _____
ICU RNs _____ and _____and_____
Respiratory Therapist _____
MICU Resident _____
Senior Resident on CCU Service _____
Surgical Resident _____
Anesthesia _____
Medicine Resident on Teaching _____
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