Quality standards for cardiopulmonary resuscitation practice and training

Primary care - minimum equipment and drug lists for cardiopulmonary resuscitation

Contents

1. Introduction and scope
2. General points
3. Equipment and drug lists
    3.1 Primary care - suggested minimum equipment
    3.2 Primary care - for skill sets needed for patients at greater risk
           3.2.1 Airway and breathing
           3.2.2 Circulation
     3.3 Notes

1. Introduction and scope

Healthcare organisations have an  obligation to provide a high-quality resuscitation service, and to ensure that staff are trained and updated regularly to a level of proficiency appropriate to each individual’s expected role.

As part of the quality standards for cardiopulmonary resuscitation practice and training this document provides lists of the equipment and drugs required for cardiopulmonary resuscitation in primary care. This document is referenced from, and is a component of, the Quality standards for cardiopulmonary resuscitation practice and training for primary care.

The core standards for the provision of cardiopulmonary resuscitation across all healthcare settings are described in:

Introduction and overview Quality standards for cardiopulmonary resuscitation practice and training

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2. General points

1. All providers of primary care must ensure that their staff have immediate access to appropriate resuscitation equipment and drugs when needed. The standard AED sign should be used in order   to reduce delay in a defibrillator in an emergency    www.resus.org.uk/defibrillators/standard-sign-for-aeds/
   
2. All staff must have a means of calling for help (e.g. internal or external landline telephone, mobile telephone with reliable signal, alarm bell, or portable radio with reliable signal.
3. Staff should be trained to use the available equipment according to their expected roles.
4. It is recognised that planning for every eventuality is complex; therefore, providers of primary care must undertake a risk assessment to determine what resources are required in their local circumstances. Risk factors to consider are:
   • patient groups (e.g. adults, children,)
   • likelihood of cardiorespiratory arrest (more patients seen in out-of-hours home visits may be at higher risk than those seen in routine daytime visits)
   • training of staff likely to be available to assist at any specific location
   • the response time for the ambulance service to be able to provide more advanced equipment and life support skills
5. This risk assessment should be overseen by a designated resuscitation lead. Expert advice should also be sought locally from those involved frequently in resuscitation (e.g. resuscitation officers, emergency physicians, ambulance services).
6. Resuscitation equipment should be for single-patient use and latex-free, whenever possible. Where non-disposable equipment is used, a policy for decontamination between use in different patients must be available and followed.
7. Personal protective equipment (e.g. gloves, aprons, eye protection) and sharps boxes must be available according to local policy.
8. A reliable system of equipment checks and replacement must be in place to ensure that equipment and drugs are always available for use in a cardiorespiratory arrest. This process should be designated to named individuals, with reliable arrangements for cover in case of absence. The frequency of checks will depend upon local circumstances but should be at least weekly.
9. The manufacturers’ instructions must be followed regarding the use, storage, servicing and expiry of equipment and drugs.
10. The precise availability of equipment and drugs should be determined locally. The lists below include recommendations on when equipment and drugs should be available:
    • Immediate - available for use within the first minutes of cardiorespiratory arrest (i.e. at the start of resuscitation).
    • Accessible - available for prompt use when the need is determined by those attempting resuscitation.
11. These lists are not exhaustive. Local experts should be consulted to ensure that appropriate equipment and drugs are available when they are needed, to enable provision of high-quality attempted resuscitation.
12. These lists refer only to equipment for the management of cardiorespiratory arrest. All organisations providing primary care should have appropriate equipment and drugs for managing other life-threatening emergencies (e.g. anaphylaxis).

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3. Equipment and drug lists

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Notes

1. The list for those with enhanced skills or covering higher-risk patients, particularly, is for guidance only. Certain organisations may have practitioners whose skills can provide more advanced care than included on this list (tracheal intubation, arrhythmia management, other critical-care skills). Organisations employing those with such skills should ensure that provision is made so that these skills can be employed to ensure that patients receive optimal care.
2. Similarly, some organisations may have staff who are not familiar with certain equipment in which case a local decision should be made as to whether training is increased to cover such skills or whether such equipment is not required.
3. Keeping resuscitation drugs locked away - this problem was addressed in detail in 2005 by the Royal Pharmaceutical Society of Great Britain in a revision of the Duthie Report (1988) ‘The Safe and Secure Handling of Medicines’. The RC (UK) responded with a statement, along with an accompanying letter written to the CQC explaining the position. www.resus.org.uk/media/statements/keeping-resuscitation-drugs-locked-away/
   

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November 2013, updated March 2018