WRH Receives Funding for 24/7 Protected Code Blue Physicians



Windsor Regional Hospital has received provincial funding to establish a new position in response to COVID-19, similar to a SWAT team, to have a physician on-site 24/7 whose sole responsibility is responding to Code Blue calls.

Code Blues are called to alert staff to a medical emergency such as a cardiac or respiratory arrest. With the additional precaution to consider that every patient could potentially be COVID positive, the role of a ‘Protected Code Blue’ physician was created.

Dr. Eli Malus, Critical Care Lead for the Erie-St. Clair Local Health Integration Network (LHIN) and ICU Specialist at Windsor Regional Hospital spearheaded the effort in talks with the province.

The additional funding allows a dedicated physician to be on site, all day and all night, to insert central lines, chest tubes, or to help perform intubations, as there are more sick patients in hospital.

“They are an extra set of hands that are highly skilled,” says Dr. Malus. “The scariest thing to do with a COVID positive patient is to put the endotracheal tube in. You are close to their face, they are getting CPR, things are being aerosolized, they are going on a ventilator, all these things are happening and it is happening close to the face of the patient.”

Therefore, having a physician that is dedicated to Protected Code Blue calls allows them to be ready with their PPE and to respond more quickly as a team as minutes can mean the difference between life and death.

The Protected Code Blue physician is also necessary because a 30-minute procedure pre-COVID, now takes two hours.

The benefits to the new position are two-fold. It means quicker response times for a patient who is having a cardiac or respiratory arrest, and “It lets the ER physician stay in the ER or it lets the ICU physician stay in the ICU so they can spend more time with their patient.”

“We are ensuring better patient care by having a better doctor-to-patient ratio,” adds Malus. “If I’m resuscitating a Code Blue and I’m in all that PPE head-to-toe and one of my other ICU patients needs help because they are all critically ill, I’m stuck in that room, I’m land-locked.”

The new position began in mid-December with funding in place until March 31, 2021.

Once the new position was approved, Dr. Malus recruited Dr. Riley Jakob, an ICU and ER doctor, to act as co-lead and assist with scheduling.

“Windsor Regional Hospital was at the right place at the right time in getting this approval,” says Dr. Jakob. “The most important rule is they (Protected Code Blue physician) can’t have any other commitments. Prior to this, it wouldn’t be uncommon for that individual to have competing interests.”

Dr. Malus adds Jessica Bennett, Director of Medical Affairs, has also assisted on the administrative side, to ensure everything ran smoothly.

Both campuses, Met and Ouellette, have a dedicated room for the Protected Code Blue Physician to stay and they are required to carry a specific cell phone to be called at a moment’s notice.

Dr. Malus and Dr. Jakob acknowledge there has been a tremendous response from physicians at Windsor Regional Hospital, willing to help out.

“We have had hundreds of requests from physicians willing to take on the shifts in February,” says Dr. Malus who took on a shift himself on Christmas day.

According to Dr. Jakob, the extra set of helping hands has helped to ‘balance the workloads of physicians dramatically’ which ultimately improves care for every patient.