Deteriorating Patients
- Early senior decision making around DNACPR, is vital for both staff, patients, and families.
- Document decsion making and communications clearly
- There will be regular updates in “handover” about ICU admission criteria – as these may change over time
CPR (Aerosol Generation Procedure)
- Recognise cardiac arrest.
- Look for the absence of signs of life and normal breathing.
- Feel for a carotid pulse if trained to do so.
- Do not listen or feel for breathing
- If there are any doubts – start chest compressions until help arrives.
- When calling for help/2222, state the risk of COVID 19.
- Minimum Level 2 PPE; gown, eye protection, gloves and surgical mask/Hood
- Rhythm assessment
- Up to 3 shocks(VF/VT)
- NO CPR
- Minimum Level 3 PPE; gown, eye protection, gloves and FFP3 mask/Hood before starting chest compressions
- No chest compressions or airway procedures such as those detailed below should be undertaken without full AGP PPE.
- Start compression-only CPR
- Avoid mouth-to-mouth ventilation and the use of a pocket mask.
- Place oxygen face mask on the patient’s face during chest compressions (may limit aerosol spread).
- Restrict the number of staff in the room (if a single room). Allocate a gatekeeper to do this.
- LMA/ETT insertion – must be carried out by experienced individuals.
- Identify and treat any reversible causes
- Post-CPR
- Dispose of, or clean, all equipment used during CPR
- Remove PPE safely to avoid self-contamination
- Hand hygiene has an important role in decreasing transmission.
- Post resuscitation debrief is important and should be planned.
FULL Resus Council – GUIDE HERE