Resuscitation Council (UK)

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Recommended Minimum Equipment for In-Hospital Adult Resuscitation

 ! This document was superseded by Quality standards for CPR practice and training.

Introduction

Provision should be made in all clinical areas to have immediate access to resuscitation drugs and equipment to facilitate rapid resuscitation of the patient in cardiopulmonary arrest. Ideally, the equipment used for cardiopulmonary resuscitation (including defibrillators) and the layout of equipment and drugs should be standardised throughout an institution.

The choice of resuscitation equipment should be defined by the resuscitation committee and will depend on anticipated workload and specialised local requirements. Whilst it is difficult to plan for every eventuality, institutions should undertake a risk assessment to determine what additional resources may be required depending on local circumstances and specific locations (e.g., in some areas there may need to be provision for failed intubation, patients with tracheostomies etc). Where possible, resuscitation equipment should be single use and latex free.

In addition to the resuscitation equipment listed below, clinical areas should have immediate access to stethoscopes, a device for measuring blood pressure, a pulse oximeter, a 12-lead ECG recorder and facilities for blood gas analysis. A method for verifying correct placement of the tracheal tube is recommended e.g., end-tidal carbon dioxide monitoring, or an oesophageal detector device.

The Resuscitation Council (UK) recommends that the manufacturer’s instructions for use and servicing are followed and that equipment and drugs are replaced before they expire.

The following items are the recommended minimum requirement.

References

  • Cardiopulmonary Resuscitation – Standards for Clinical Practice and Training. A Joint Statement from the Royal College of Anaesthetists, The Royal College of Physicians London,  The Intensive Care Society and the Resuscitation Council (UK).   October 2004.
  • Common faults in resuscitation equipment - guidelines for checking equipment and drugs used in adult cardiopulmonary resuscitation.  Dyson E, Smith GB. Resuscitation 2002;55:137-49.
  • Potassium chloride concentrate solutions. Patient safety alert.
    The National Patient Safety Agency. July 2002.

Recommended Minimum Equipment

Airway equipment

  • Pocket mask with oxygen port (should be widely available in all clinical areas)
  • Self inflating resuscitation bag with oxygen reservoir and tubing (ideally, the resuscitation bag should be single use – if not, it should be equipped with a suitable filter)
  • Clear face masks, sizes 3,4 & 5
  • Oropharyngeal airways, sizes 2, 3 & 4
  • Nasopharyngeal airways, sizes 6 & 7
  • Portable suction equipment
  • Yankauer suckers
  • Tracheal suction catheters, sizes 12 & 14
  • Laryngeal mask airways (sizes 4 & 5), or ProSeal LMAs (sizes 4 & 5), or Combitube (small)
  • Magill forceps
  • Tracheal tubes – oral, cuffed, sizes 6, 7 & 8
  • Gum elastic bougie or equivalent device
  • Lubricating jelly
  • Laryngoscope handles (x 2) and blades (standard and long blade)
  • Spare batteries for laryngoscope and spare bulbs (if applicable)
  • Fixation for tracheal tube (e.g., ribbon gauze/tape)
  • Scissors
  • Selection of syringes
  • Oxygen mask with reservoir (non-rebreathing) bag
  • Oxygen cylinders
  • Cylinder key

Circulation equipment

  • Defibrillator (shock advisory module and or external pacing facility to be decided by local policy)
  • ECG electrodes
  • Defibrillation gel pads or self-adhesive defibrillator pads (preferred)
  • Selection of intravenous cannulae
  • Selection of syringes and needles
  • Cannula fixing dressings and tapes
  • Seldinger central venous catheter kit
  • Intravenous infusion sets
  • 0.9% sodium chloride - 1000 mL x 2
  • Arterial blood gas syringes
  • Tourniquet

Drugs

a) Immediately available prefilled syringes
  • Adrenaline (epinephrine) 1 mg (1:10,000) x 4
  • Atropine 3 mg x 1
  • Amiodarone 300 mg x 1
b) Other readily available drugs

     Intravenous medications:

  • Adenosine 6 mg x 10
  • Adrenaline 1 mg (1:10,000) x 4
  • Adrenaline 1 mg (1:1,000) x 2
  • Amiodarone 300 mg x 1
  • Calcium Chloride 10 mL of 100mg per mL x 1
  • Chlorphenamine 10 mg x 2
  • Furosemide 50 mg x 2
  • Glucose 10% 500 mL x 1
  • Hydrocortisone 100 mg x 2
  • Lidocaine 100 mg x 1
  • Magnesium Sulphate 50% solution 2 g (4 mL) x 1
  • Midazolam 10 mg x 1
  • Naloxone 400 mcg x 5
  • Normal Saline 10 mL ampoules
  • Potassium Chloride for injection (See NPSA Alert)
  • Sodium Bicarbonate 8.4% - 50 mL x 1

Other medications / equipment:
  • Salbutamol (5 mg x 2) and Ipratropium Bromide (500 mcg x 2) nebules
  • Nebuliser device and mask
  • GTN spray
  • Aspirin 300 mg

Additional items

  • Clock
  • Gloves/Goggles/Aprons
  • Audit forms
  • Sharps container and clinical waste bag
  • Large scissors
  • Alcohol wipes
  • Blood sample bottles
  • A sliding sheet or similar device should be available for safer handling      

 

October 2004

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