Cardiac Arrest Record Fiona Barton Senior Resuscitation Officer

Cardiac Arrest Record Fiona Barton Senior Resuscitation Officer University Hospital Kerry IARO 7 th April 2017 Mullingar

Why? Collection of Utstein data Guidance for Resuscitation Team during and after an event Accurate patient notes

Patient records Audit unveiled many cases of inaccurate or incomplete recording of event by different healthcare professionals. ‘Move patient to ICU for ventilation and post ROSC care’ Medical Reg ‘Keep in medical ward on CPAP’ Anaesthetic Reg ‘PEA shocked x 2’ Medical SHO ‘VF shocked x 1 ED RGN

Patient records Time not recorded at all or using 12 hour clock. Impossible to tell who had actually attended the event. Lots of recording of ‘resuscitation attempted as per ACLS guidelines’. Route of drug administration not easy to identify. Inconsistent post ROSC orders.

Utstein data Updated in 2015

Guidance for team Aid memoire for staff working in high pressure situation. Peri arrest guidance Hs and Ts memoire Ease of recording for time keeper Checklist for post ROSC care Aids team debrief

Situational Awareness is… the ability to identify, process, and comprehend the critical elements of information about what is happening to the team with regards to the mission. More simply, it's knowing what is going on around you. US Coastguard

Team Debrief A brief review with the goal of reflecting both negative and positive events whilst still vivid in the mind of team members, and to identify and promptly address issues regarding equipment or processes.

Why debrief? Effective communication tool Ongoing process improvement Reduction of provider stress and burnout.

How? Make it part of EVERY 2222 call Time limit to between 5 -10 minutes Find a suitable corner Record result. Action what can be actioned. Escalate what needs to be escalated.

Post Event Debrief Pre-Alert Information: (Correct call for correct team to correct location) Initial team Organisation: ( Well organised, Team leader, Clear Team & Role allocation) Main Event: ( Correct guidelines, Situational awareness, Team dynamics, Close Loop Communication) Event Completion/ Outcome: (Agreement to stop CPR, Correct management of ROSC) Post Event Administration: (Completion of paperwork, Tidy up and prepare, Thank everyone involved)

Post ROSC Care