If he experiences an acute change but he's still stable, contact the physician on call stat to report your findings and obtain orders. As indicated, start oxygen, establish I.V. access, and make sure the crash cart is nearby, just in case. If his condition warrants numerous, frequent stat calls to the departments that normally respond in a code, it may also be time to call a code. If your patient's deteriorating condition requires help from most of the nurses in your unit, you probably need the code team. To summarize, the keys to evaluating gray areas are to determine how significant this change in the patient's condition is, how rapidly his condition is deteriorating, and how many staff members are needed to manage his condition.
Some situations have no gray areas.
If your patient is unresponsive and pulseless or not breathing, initiate a code. Call out for help. Announce that this is a code and give your location. In most institutions, the unit secretary activates the code team via telephone. Position the patient supine, open his airway, and initiate breathing as appropriate, observing universal precautions.