Roles of anesthesia assistants within the code blue team at in-hospital cardiopulmonary arrests: A retrospective analysis
Bibliographic record
Abstract
Introduction: Anesthesia assistants (AAs) are respiratory therapists or nurses who have additional sub-specialty training in the provision and maintenance of anesthesia. Their skill set includes advanced airway management, vascular access, and knowledge of vasoactive medications and resuscitative protocols. AAs function as non-physician members of the anesthesia team and can act as physician extenders to help offset the current shortage of anesthesiologists. Methods: This study was a retrospective analysis of AA roles at code blue events at an adult academic teaching centre. Data was extracted from administrative data collection forms completed by AAs at adult code blue events between 2017 and 2022. The data elements that each form captured included time and location of event, presumed cause of the code, airway management details, vascular access provision, medication preparation or administration, human factors and cognitive supports provided to the team by the AAs. Results: Administrative data collection forms from 320 code blue events were analyzed in this study. The most common primary causes of the code blue events were "arrest" (39%) and "respiratory failure" (26%). Regular floor beds (47%) and the intermediate care units (18%) were the most common locations of code blue events. Airway support was required in 77% of the codes, and in 50% of the cases requiring intubation, it was performed by the AAs. The first pass success rate for AA intubations was 83%, and overall success rate was 96%. In addition to airway management at codes, the AAs also reported providing numerous other valuable contributions to the team. The most reported supports provided to the team included cognitive support regarding resuscitation (49% of cases), intravenous access (19% of cases), and medication preparation or administration (9% of cases). Other roles included placement of arterial lines and drawing blood gases, obtaining interosseous vascular access, and assisting with patient transport to critical care units after resuscitation. Conclusions: Our study characterizes the supporting roles that AAs can provide as members of the code blue team and demonstrates their contributions to management of critically ill patients. The AAs' airway management, vascular access skillsets, and knowledge of vasoactive and resuscitative medications and protocols make them well-suited to the code blue team. In addition to assisting within the operating room team, AAs can also provide valuable support in non-operating room environments such as cardiopulmonary arrests.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".