CODE BLUE FORM
DATE: TIME: (Military Time) FOUND BY: LOCATION: CONDITION: CPR Initiated Military TIME Intubation Military TIME Central Line Placement Military TIME Other Military TIME ( Describe ) > > Epinephrine Bolus Syr. Atropine Bolus Syr. Lidocaine Bolus Syr. Sodium Bicarbonate Bolus Syr.
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