All methods described here were exempt from review by the Summa Institutional Review Board. 
1. Preparation
Prepare the simulation lab prior to beginning the blindfolded code training exercise. 
Prepare all supplies needed for code resuscitation, including an intravenous (IV) start kit, IV fluids, a code cart, a defibrillator with pads, a bag valve mask, a non-rebreather mask, a nasal cannula, a pulse oximeter, and intubating supplies (including a laryngoscope, an endotracheal tube, a stylet, a syringe, an end-tidal carbon dioxide monitor, and a cardiac monitor).
Place the human-patient simulator on an emergency department bed. Turn on the simulator and connect it to the wireless network. Set the simulator vitals to match the case scenario.
Provide a chair or stool and blindfold for the code team leader. Place the team leader 5 feet away from the foot of the bed, facing away from the team. 
Print code resuscitation simulation scenarios for the faculty. Read the simulation scenarios prior to the start of the session. 
Upload any necessary radiographic images and electrocardiograms for each patient scenario.
2. Blindfolded Code Training Exercise
Review the rules of the exercise with the learners. Provide a demonstration for the learners of the blindfolded code training exercise.
Select a code team leader from the group of learners. Initially, start with more experienced learners as code team leaders.
Sit the code team leader down on a chair or stool at the foot of the bed, facing away from the patient. Blindfold the code team leader. 
NOTE: The best resuscitation team configuration is one embedded nurse, three resident physicians, and one resident as code team leader. Ensure that resuscitation team members verbally introduce themselves by role, name, and position in relation to the patient in the bed to the blindfolded code team leader prior to the start of the scenario. 
NOTE: For example, “I am resident John at the head of the bed.”
Start the scenario by reading the stem for the case scenario to the code team leader.
Run the case scenario for approximately 8–10 min. Change the patient vitals and cardiac rhythms in alignment with the case scenario outline. 
3. Blindfolded Code Team Debriefing
Debrief the code team at the conclusion of the case scenario for approximately 10 min. 
NOTE: Focus on the utilization of closed-loop communication, the leader’s effectiveness in leading the resuscitation, and the management decisions as they relate to the advanced cardiac life support (ACLS) or advanced trauma life support (ATLS) algorithms. 
Select another code team leader and repeat the process at the conclusion of the debriefing.
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