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Medical Emergencies and Resuscitation Policy Version: 7 SH CP 30 Medical Emergencies and Resuscitation Policy Version: 7 Summary: The purpose of the policy is to provide direction and guidance for the planning and implementation of a high-quality and robust resuscitation service ensuring a consistent approach is applied in relation to the management of cardiopulmonary resuscitation and medical emergencies across the Trust. Keywords (minimum of 5): Asthma, Anaphylaxis, Cardio Pulmonary (To assist policy search engine) Resuscitation, Cardiac Emergencies: Angina & Myocardial Infarction, Choking and aspiration, Hypoglycaemia, Life support training, Medical emergency, Resuscitation equipment, Seizures, Syncope (fainting), The use of oxygen in an emergency. Target Audience: All staff involved with patient care Next Review Date: October 2021 Approved & Ratified by: Date of meeting: Resuscitation Group 1st April 2019 Date issued: March 2020 Author: Hayley Stockford, Resuscitation Officer Accountable Executive Lead: Karl Marlowe, Medical Director 1 Medical Emergencies & Resuscitation Policy Version: 7 July 2020 Version Control Change Record Date Author Version Page Reason for Change 18.07.16 Hayley Stockford 2 All Policy Review: Resuscitation Updated guidance in line with Resuscitation Guidelines 2015 and RCUK Officer Quality Standards, references and associated documents 16.08.16 Hayley Stockford 2 Amendments to equipment provision and checking requirements as Resuscitation 8 – 9 requested by CQC Delivery Meeting: Officer 54-59 Removed “ minimum monthly checks” to “daily checks” 54-57 Removed resuscitation equipment checking documents Added new resuscitation equipment checking documents 05.09.16 Hayley Stockford 2 5 Addition of adult, child and infant to definitions Resuscitation 55 Change presentation of midazolam Officer 55 Addition of needles and syringes to checklist February Hayley Stockford 3 8-10 Policy reviewed as part of the Trust wide standardisation of 2017 Resuscitation 46 resuscitation equipment as part of a managed service, for inpatient Officer settings. October Hayley Stockford 4 8 Section 5.2 Removal of pocket mask and first aid kit provision 2017 Resuscitation requirements Officer A5 Addition of LNFH management of opioid overdose October Hayley Stockford 5 Addition of emergency medications guidance in appendices 2018 Resuscitation Amendment of post choking incident recommendations in appendix Officer Update logo and Accountable Executive Lead April Resuscitation 6 All Policy Review: 2019 Group January Kerry Lewis: 7 All Amended references to Emerade autoinjectors, amended Anaphylaxis 2020 Resuscitation section to reflect current use of ampoules, syringes and needles to Officer deliver Adrenaline. July 2020 Kerry Lewis: 7 56 Removal of Opiod overdose algorithm from appendix 6. This information Resuscitation is already included on page 45 Officer 30/11/20 Cara Aldous- 7 10 Updated link in section 5.9 Boyes 8/3/21 Review date extended from April to October 2021 Reviewers/contributors Name Position Version & Date Simon Johnson Head of Essential Training Karen Osola Trust Lead ECT Nurse Sophie Tomkins Clinical Audit Facilitator Steve Mennear Senior Clinical Pharmacist Tracy Hammond Medical Devices Advisor (MDSO) Hayley Stockford Resuscitation Officer Helen Collins Resuscitation Officer Kerry Lewis Resuscitation Officer Rachel Anderson Clinical Director (LNFH) Alan Chambers Procurement Manager Helen Ludford Associate Director of Quality Governance Julia Lake Interim Divisional Director of Nursing and Allied Health Professionals Sara Courtney Deputy Director of Nursing Paula Hull Chief Nurse Carol Adcock Associate Director of Nursing for AMH and OPMH Uresh Fernandez Consultant, Specialised Services James Waller Consultant Cardiologist, LNFH Dawn Buck Head of Patient and Public Engagement Sharon Harwood OPMH, Matron Karen Dixon CAMHS Service Manager John Stagg Associate Director of Nursing, AHP and Quality, Learning Disabilities Laura Pemberton Associate Director of Nursing and AHPs, Southampton Tracey McKenzie Head of Compliance Assurance and Quality Vanessa Lawrence Deputy Chief Pharmacist Kathy Jackson Head of Nursing and AHPs, OPMH Beverley George Integrated Services Matron Susan Tatsinkou Head of Nursing Children and Family Services Sarah Constantine Deputy Medical Director Nathan Clifford Expert By Experience Co-Ordinator 2 Medical Emergencies & Resuscitation Policy Version: 7 July 2020 CONTENTS Section Title Page 1. Introduction 4 2. Scope 4 3. Definitions 5 4. Duties and responsibilities 5 5. Main policy content 7 6. Financial impact & resource implications 11 7. Training requirements 11 8. Monitoring compliance 12 9. Policy review 12 10. Associated trust documents 12 11. Supporting references 13 Appendices A1 Training Needs Analysis (TNA) 14 A2 Equality Impact Assessment (EqIA) 16 A3 Guidance sheet for summoning appropriate help in the event of a 24 medical emergency or cardiac arrest A4 Use of Oxygen during a medical emergency 26 A5 Medical Emergencies 29 – 45 ABCDE approach Asthma Anaphylaxis Cardiac Emergencies Seizures Hypoglycaemia Syncope (fainting) Choking Opiate overdose A6 Emergency algorithms 46 – 59 A7 Resuscitation Event Report Form 60 3 Medical Emergencies & Resuscitation Policy Version: 7 July 2020 Medical Emergencies and Resuscitation 1. Introduction 1.1 Southern Health NHS Foundation Trust (the Trust) recognises and accepts its responsibility to employees, patients, families and carers to ensure that the requirements for resuscitation (HSC 2000/028) are satisfied. 1.2 The Trust must provide a resuscitation service for patients, service users, visitors and staff on all of its sites. The aim is that all relevant staff defined within the TNA of this policy must be able to provide cardiopulmonary resuscitation (CPR) at a level appropriate to their role and healthcare environment in which they are working. As a minimum this is Basic Life Support (BLS). However, some staff (e.g. Doctors, Dentists, Registered Nurses & Allied Health Professionals) must provide elements of enhanced life support via Immediate Life Support (ILS). Please refer to TNA in Appendix 1 for requirements. 1.3 The Trust will take all reasonable steps to provide the initial first aid response for medical emergencies and in all instances refer for subsequent specialist treatment and care. It is important that emergency medical aid is sought immediately to improve the possibility of the patient’s outcome. It must be recognised that many resuscitation attempts will not be successful despite the best efforts. 1.4 Any persons suffering a cardiac or respiratory arrest on Trust premises, or while being attended to by a Trust employed health professional in other settings, should be considered for CPR unless an appropriate Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decision or advanced directive is in force. The Trust has a unified Do Not Attempt Cardiopulmonary Resuscitation (uDNACPR) policy which should be read in conjunction with this policy to ensure that CPR is only initiated for patients when it is appropriate and in their best interests. It is the responsibility of each member of the multidisciplinary team to know whether a patient is for CPR or not. All teams within the Trust should establish a process to ensure this responsibility is recognised. If there is any doubt about the CPR status of an individual, resuscitation should be commenced. 1.5 This Medical Emergency and Resuscitation policy is based on the Quality Standards for Cardiopulmonary Resuscitation Practice and Training published by the Resuscitation Council (UK) (November 2013, updated 2014, 2016, 2017) and has been developed to describe the process for managing and mitigating risks associated with resuscitation, as detailed in current NICE Guidance, The ECT Handbook (Royal College of Psychiatrists 2005, updated 2013), the Mental Health Act Revised Code of Practice (2015) and Resuscitation Council (UK) Decisions Relating to Cardiopulmonary Resuscitation (2014, updated 2015, 2017) for use within the Trust. 1.6 Resuscitation Services are controlled and reviewed by the Trust Resuscitation Group. The Resuscitation Officers/trainers will offer training to staff according to the needs of the service area and the responsibilities given to them as part of its duty of care to patients. 2. Scope 2.1 The document applies to all Trust staff and identifies the: Accountabilities, responsibilities and duties of staff Mandatory training requirements of staff Process for procuring, storing, replenishing, maintaining and cleaning of emergency and resuscitation equipment Procedure in relation to the initiation of resuscitation including obtaining emergency assistance Post incident reporting, recording, reviewing and support procedures in relation to resuscitation events Process for monitoring compliance with the policy. 4 Medical Emergencies & Resuscitation Policy Version: 7 July 2020 3. Definitions Ambulance Emergency ambulance following “(9) 999” call CPR Cardio Pulmonary Resuscitation DNAR Do Not Attempt Resuscitation DNACPR Do Not Attempt Cardio Pulmonary Resuscitation uDNACPR unified Do Not Attempt Cardio Pulmonary Resuscitation BLS Basic Life Support ILS Immediate Life Support AED Automated External Defibrillator NEWS National Early Warning Score TNA Training Needs Analysis SBAR (D) Situation, Background, Assessment, Recommendation and Decision – Please see Physical Assessment and Monitoring Policy HCPs Health Care Professionals, staff who are registered with their appropriate governing body (eg. GDC, GMC, HPC,
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