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NURS1131 In-depth Analysis of Video: Code Blue Simulation Assessment Answer

Media annotation submit your finished assignment here

NURS1131 - Media annotation submit your finished assignment here

This part of the assessment requires the student to review a video of a skill associated with the course and assess the performance of the skill, analyse the video for quality of performance and identify the strengths and weaknesses of the performance based on cited research.

Instructions for the Media annotation

Please make sure you indicate which video you reviewed on your submission

The media annotation requires you to review a video of an arrest scenario associated with the course and assess the performance of the skill.

The BLS/ ALS videos on the canvas website must be used.

You need to analyse the video for quality of performance and identify practices not in line with the ARC guidelines and identify the strengths and weaknesses (technical and nontechnical) of the performance based on cited research. You can provide recommendations for practice change. For all the discussion you need to link to the ARC guidelines specifically and identify the research to provide evidence to support your comments and or recommendations made for improving performance.

There are many journals with research into BLS and ALS so try and use these rather than a website (although the ARC website does provide reliable information as well. Examples of journals available via the library include: Resuscitation, Chest, Heart and Lung).

Word limit – 1500 - 2000

An example Media Annotation

"After reviewing the video scenario several areas of poor performance were identified. In this assignment the video scenario will be analysed and positive and negative issues identified and discussed based on the available evidence.

It was noted the depth of compression appeared inadequate on multiple occasions. According to Smith and Jones (2014) depth of compression of at least 5cm is necessary to generate a cardiac output. Several studies have identified the importance of compression depth during cardiac arrest (Frank, 2015; Smyth, 2011; Simmonds, 2012; Alfonso & Sidonas, 2005). Franks (2105) study of survival from cardiac arrest found a statistically significant relationship between ROSC and compression depth. Those patients who had compressions of 6 cm had a greater likelihood of ROSC compared to those with a compression depth less than 5cm (p=0.01)."


NURS1131 Media annotation


The purpose of the essay is to discuss in-depth analysis of the video "Code Blue Simulation - Virtual Education and Simulation Training Center”; the use of the simulating medical training has been becoming a more engaging and also valuable tool that could help to derive the quick explanation as to what can be the key learning while doing a medical training (Bryony, 2019) Further, it would be helpful to have the use of the simulation in medical training and also devise applications in an emergency, surgical, and nursing education. Due to the active working of the registered nurses working within the surgical inpatient units that would be required to be part of the mock code simulation and also seek active participation in the practice skills, improve knowledge along with focusing on the build self-confidence and also being able to handle the most of the safe and controlled environment. Simultaneously, the simulation scenario would be encouraged to use the high-fidelity mannequin which would help to check the actively engaged adaptive methodology for the CPR (Scerri, 2019). 


In the video, one could see the nurses and the doctors, enacting to take care of the rehearsing response protocol for the patient in the cardiac arrest.  As one could see how the patient (mannequin) was lying down and had a cardiac arrest, the nurse enters the room and checks the patient vital signs. She tries to revive the patient's condition by actively pumping the chest and even doing  a mouth to mouth revival and tries to revive the patient condition (Smith & Jones, 2014). The other nurses also step in with the other medical equipment and the other revival kits, but the nurses look calm, was not in rush and even used the technique of reviving the chest pressing and even trying to activate the patient. However, the technique to press the chest was not correct, as the hands were placed incorrectly and even the technique was not hard to revive up. Subsequently, besides to the patient, one could see, charts bed and the other vital charts, but the nurse does not even check those and does not repeat the vitals. Then in the 30 seconds, after the patient is arrested, it was important for the nurses to enact quickly an even to do the Code Blue, which is an active effective response to the respirations with BVM and also engaging n the start compressions, along with using the adequate techniques (White-Williams et al, 2020). The nurses were also supported to record the events, switch on the CPR, which was not done timely. As observed, even after all the tasks were performed, one could see how the clinical educator who was playing the role of the resident while the other was playing the roles of the nurses and the others, was the role of the resident. One could see how in the video, the team lead role was to check for the cardiac arrest algorithm and even to give the first dose of epinephrine after which the client response of spontaneous circulation (ROSC) should have been checked. It was important in the video, to timely also monitor the blood pressure and oxygen saturation readings which was not done timely and one could see the other trainees and part of the enact, losing interest and did not respond well on time. In the video, one could see the visual feedback (such as the chest to rise) which was an important event to check, what kind of the process, technique, and methodology which the patient was experiencing (Norton, 2020). As noted in the case, there has been an in-depth comparison of how the inadequate use of the technique can cause multiple problems and on various occasions. As per the Smith and Jones, (2014) analysis of the compression of at least 5cm was a necessity in order to generate the cardiac output, which has been similarly been identified as the core importance in the compression depth and also how the cardiac arrest can even cause the problem during the survival stages. It was also found to have the statistically significant relationship which can exist in between the ROSC and compression depth, and it was important for the patients to focus on the compressions of 6 cm which had looked familiar with the likelihood of ROSC compared to as compared to the compression placed with the depth of the less than 5cm (p=0.01) (Rosengren, 2019).

Breaches to the Australian resuscitation Guidelines

As per the “Australian resuscitation Guidelines”, it is important to ensure and abide by the protocols of the 1. Rescuers would begin the start of the CPR if the person has further become unresponsive and even is not being able to breathe properly (Australian resuscitation Guidelines, 2018). 2. Further, the Bystander CPR needs to also actively be part of the process and are encouraged.  3.  It is important to focus on the compression-to-ventilation ratio which needs to be 30:2 for all ages (Bryony, 2019) 4. Depending on the rescuers performing the chest compressions it is evident that if not breathing normally, then the rescuers that are not trained and are not willing to give the rescue breaths are encouraged not to do so (Smith  & Jones, 2014). 5. Chest compressions can also be performed at a rate of approximately 100 – 120 /min (Smith & Jones, 2014). 6.. The rescuers must focus on the ways to minimize interruptions and also work over the chest compressions (Hedqvist, 2019).

3.1 Chest Compressions

As observed, how the rescuers would be able to perform the chest compressions and it would be done during the stages of the unresponsive and not during the time of the breathing normally (Australian resuscitation Guidelines, 2018).

Subsequently, the duty of the ANZCOR which mentions, how to train, guide, and even join hands with the wiliness to revive the patient, can be a crucial part of the act in the cardiac arrest. Another factual finding is how the rescuers would also continue to do the continuous chest compressions which would be as a result of the rate of approximately 100 –120 /min.1 (Australian resuscitation Guidelines, 2018).

3.2 Minimize Interruptions to Chest Compressions

In the act of the CPR, it is important not to interrupt and also keep on checking for the response on the breathing. As per the ANZCOR the minimized interruptions is important to check along with the chest compressions. The prime work for the workers is to focus on the practicalities of delivering and in here, there would be the effective breaths that would exist in the cycles of chest compressions which would be substantially  following the patient which would be without the advanced airway (Papanikolas, 2019).  

3.3 Multiple Rescuers

Another finding is that there should be numerous rescuers that can be available and it is important to ensure that there can be also the ambulance that would be called, the role of the available equipment that can also be obtained (e.g. AED) (Evén, 2019).

3.4 Duration of CPR

It is important to note the duration of the CPR activity which is to check for the cardiopulmonary resuscitation and also identify the below conditions are met-:  

• The person can respond and eve being able to breathe normally

• To further check for the impossible ways to continue (e.g. exhaustion)

• To check for the health care professional after the arrival with the CPR (Caspar, 2019)

• A health care professional needs to also enact responsibly while ceasing the CPR (Bryony,  2019) 


In the case, as observed the breaches were in the below findings-:

The healthcare did not indicate the ceasing of the CPR activity.

The multiple rescuers did come, but they were slow in the act and even failed to obligate their duties and the guidelines.

The CPR was not performed for the 30 seconds of time (Bryony,  2019)

The patient condition was already seemed to be not reviving and there was also an indication that the CPR was not done correctly.

The breach was also identified in not timely recording the information, identifying the vital signs, and even delaying the technique (White-Williams et al,  2020).

Non-technical Skills

As observed, in the video, that shows, how the registered nurses had increased levels of comfort level and observed, each of the nurses to be highly skilled, experienced nurses, who can respond with anxiety with respect to the code. This anxious response would further also evaluate how there can be an indication of the initiating cardiopulmonary resuscitation and depending on the responder experience, the patient condition could have been recorded (Smith & Jones, 2014). As seen, in the video, even during the highly stressful conditions, the nurses were struggling to get the equipment and further, the nurses were unable to coordinate for the arrest cart, defibrillator, along with devising the BVM device. It would have been good step to use of the backboard placement can also be corrected, compressions that were not ventilations which were not adequate (Bryony, 2019). The integration of the high-fidelity nursing simulation, which would not be replaced and how it would not be working in line to the patients, which would help to provide an opportunity that would work alongside for the participants to learn technical skills and also obligate to follow the confidence that could cause a no risk to the patient (Hughes, 2019).

In the video, the simulation was developed in accordance with the guidance to the registered nurses and also who were working in the surgery inpatient units (Glasgow, et al, 2019). From the video, the key findings were as follows-:

1. To understand the growing signs of the deterioration that can eventually help in determining the patient’s condition and also applying in relation to the team approach to care; 

2. The prime goal of initiating timely and also following the Code Blue response; 

3. Obligating and also providing efficient patient care that could be part of the Code Blue and also how to follow in accordance to the resuscitation team (Morton, 2019)

 4 Subsequently how there can be a key demonstration that could help in the clear, effective communication techniques that can work in accordance with the health team members (Evén et al, 2019).

In the case, the evidence can be drawn on how the scenario has helped to develop a key plan in accordance with the simulation and how to decisions related to reviving up the patient conditions was learned by the trainees (Hughes, 2019). All the nurses were able to follow key instructions and abide by the instructor who has to complete the task that could dry run in accordance with the scenario that can follow the target population (Hedqvist, 2019). The purpose of the task was well in scope of the learning. Knowledge gaps can also follow how the errors can be a scope of the key learning that could debrief along with the post-scenario didactic sessions (Lester, 2019).

Evidence Base

In the given video, the evidence is the simulation-based medical education and how it has been evolving with the allowed trainees who could practice skills and even work over the expand knowledge along with building the self-confidence in a safe along with the controlled environment which would help to identify with the patient risks. The use of the high-fidelity mannequin simulator and even how the participants were able to practice clinical skills, and also work in accordance with the mannequin (imagining the patient response to the action ) and was positioned in accordance to response of the students’ actions or inactions. Subsequently the, registered nurses were able to examine within the inpatient units who expressed the interest to be part of the simulation (Lester, 2019). The nurses were able to follow the Quality, Patient Safety, and Risk Management Department and were able to handle the staff concerns and also seek active participation in the code and also how to follow the practice in accordance to the code in a safe, simulated environment which can help to identify how the confidence to improve the patient safety (Glasgow, et al, 2019). 


Code Blue situations video was very interesting and was also demanding and emotionally challenging. It was also important to note, how at the practice, it has influenced the controlled environment which would have been key benefits for the registered nurses and also integrating the improved patient outcomes. The purpose of the video Code Blue simulation has helped to create a deep impact on the technique used and also for the post-scenario didactics along with the teaching, designed that can help the registered nurses to follow the process.

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