2.4.06 Resuscitation instruction

1 Purpose and objective

Hospital-wide instructions for cardiac and respiratory arrest Provision of a resuscitation team, alarm procedure, equipment, qualification requirements

In the event of circulatory arrest and the resulting loss of vital functions, cardiopulmonary resuscitation (CPR) aims to restore circulatory function. This can only be achieved with rapid and appropriate action.

The aim is to temporarily maintain cardiac and circulatory function mechanically in order to prevent hypoxic organ damage. Only standardized procedures of targeted and effective action ensure our patients' chances of survival.

2 Scope of application

These instructions apply to all qualified nursing staff at the University of Cologne Hospital for cardiopulmonary resuscitation of adults and for resuscitation of children aged 8 and over. For children under 8 years of age, some special features must be observed during resuscitation (see appendix).
Indication : Cardiovascular arrest
Respiratory arrest

3 Description of the procedure

- Emergency determined (check consciousness, breathing, pulse)
- Make an emergency call
- Emergency numbers: ZNA Internal Intensive Care
- Message : WHO is calling ?
WHERE are they located?
WHAT has happened?

Waiting for queries !

- Bring the ambu bag, mask and emergency kit to the patient
- Place patient in supine position on a hard surface, open clothing
- Clear / keep airways clear
- Check breathing

Self-breathing available ? YES
Stable lateral position NO Resuscitation

2 x ventilation (Ambu bag with oxygen connection)
15 x cardiac massage (frequency = 100/min)
Perform resuscitation measures until the resuscitation team arrives; the extended resuscitation measures are based on a defined algorithm (see point 7 Applicable documents).

4 Documentation

The event must be fully documented in the patient file. It is important to record the exact time (start/end) and the sequence of resuscitation measures. All vital parameters measured during the resuscitation should also be recorded. The medication administered should be recorded according to active ingredient, dose, route of administration, time and prescribing physician.

5 Resources

CPR measures must be started immediately. They can only be handed over when the resuscitation team arrives.
If there is sufficient staff on a ward, two nursing staff remain with the patient to be cared for. The others should ensure privacy (patients, visitors) and free access for the resuscitation team

6 Notes and comments

The ANR guideline 2000 for cardiopulmonary resuscitation states: "The diagnostic uncertainty of pulse monitoring, which has been proven in several studies, has led to it no longer being recommended for lay resuscitation.
The search for general signs of circulatory function has also been added for medical personnel and should be carried out in addition to the pulse check, which must not last longer than 10 seconds." "Performing chest compressions without ventilation makes more sense than no resuscitation measures at all."
"The outstanding value of defibrillation for patients with ventricular fibrillation is again clearly emphasized in the new guidelines. The statement that the chance of survival decreases by up to 10 % with every minute until defibrillation still applies."
The resuscitation team in the Central Emergency Department offers the opportunity to reflect on the emergency situation in a joint discussion the day after a resuscitation and to discuss any problems that have arisen. To do this, each ward concerned must take the initiative to request a meeting.
QM offers courses whose content is coordinated with the nursing management, the anesthesia department, the central emergency department and the intensive care and anesthesia training center.
The aim is to train every employee of the University of Cologne Hospital every two (alternatively: three) years.

7 Applicable documents

7.1 Literature, regulations

Color-coded, modular algorithm for cardiopulmonary resuscitation from the Emergency Medicine and Rescue Working Group of the Ludwig Maximilian University of Munich
The 2000 Guidelines for Cardiopulmonary Resuscitation, ANR
M. Ruppert, A. Dorsch, Chr. K. Lackner ; www.anr.de
An appropriate guideline is still being selected for the resuscitation of children under 8 years of age.

7.2 Terms

Edit

Attachments

Algorithm for cardiopulmonary resuscitation
The 2005 guideline for cardiopulmonary resuscitation