New training and practice guidelines are being issued today for healthcare staff responsible for resuscitating patients who have stopped breathing or whose heart has stopped.
The guidelines do not cover resuscitation itself (separate guidelines exist), but service organisation, training, equipment and facilities needed to ensure the best possible chance to save patients’ lives.
Each year in England, approximately 43,000 patients in hospitals have a cardiac arrest. In addition, there are many more who receive resuscitation in other healthcare settings. Up until now, there have been no nationally agreed guidelines for standards of education, training and facilities and practice has been variable.
Now, a joint statement from the Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society and the Resuscitation Council, provides advice to UK healthcare organisations, resuscitation committees and resuscitation officers on all aspects of the resuscitation service.
It includes sections on resuscitation training, resuscitation equipment, the cardiac arrest team, cardiac arrest prevention, patient transfer, post resuscitation care, audit and research. The document should prove useful to those whose role it is to provide a safe and effective resuscitation service within their working environments, and it is hoped that these guidelines will significantly improve the provision of care for patients undergoing attempts at resuscitation in the UK. The main recommendations are:
- Healthcare institutions should have, or be represented on, a resuscitation committee that is responsible for all resuscitation issues.
- Every institution should have at least one resuscitation officer responsible for teaching and conducting training in resuscitation techniques.
- Staff with patient contact should be given regular resuscitation training appropriate to their expected abilities and roles.
- Clinical staff should receive regular training in the recognition of patients at risk of cardiopulmonary arrest and the measures required for the prevention of cardiopulmonary arrest.
- Healthcare institutions admitting acutely ill patients should have a resuscitation team, or its equivalent, available at all times.
- Clear guidelines should be available indicating how and when to call for the resuscitation team.
- Cardiopulmonary arrest should be managed according to current national guidelines.
- Resuscitation equipment should be available throughout the institution for clinical use and for training.
- The practice of resuscitation should be audited to maintain and improve standards of care.
- A do not attempt resuscitation (DNAR) policy should be compiled, communicated to relevant members of staff, used and audited regularly.
- Funding must be provided to support an effective resuscitation service.
Dr David Gabbott, Co-Chairman Working Group and Consultant Anaesthetist, Resuscitation Council, said: