Resuscitation Council (UK)
Primary care - equipment and drug lists

Quality standards for cardiopulmonary resuscitation practice and training

Primary care - minimum equipment and drug lists for cardiopulmonary resuscitation

 

1. Introduction and scope

Healthcare organisations have an  obligation to provide a high-quality resuscitation service, and to ensure that staff are trained and updated regularly to a level of proficiency appropriate to each individual’s expected role.

As part of the quality standards for cardiopulmonary resuscitation practice and training this document provides lists of the equipment and drugs required for cardiopulmonary resuscitation in primary care. This document is referenced from, and is a component of, the Quality standards for cardiopulmonary resuscitation practice and training for primary care.

The core standards for the provision of cardiopulmonary resuscitation across all healthcare settings are described in:

Introduction and overview Quality standards for cardiopulmonary resuscitation practice and training

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2. General points

 
  1. All providers of primary care must ensure that their staff have immediate access to appropriate resuscitation equipment and drugs when needed. The standard AED sign should be used in order   to reduce delay in a defibrillator in an emergency    www.resus.org.uk/defibrillators/standard-sign-for-aeds/
  2. All staff must have a means of calling for help (e.g. internal or external landline telephone, mobile telephone with reliable signal, alarm bell, or portable radio with reliable signal.
  3. Staff should be trained to use the available equipment according to their expected roles.
  4. It is recognised that planning for every eventuality is complex; therefore, providers of primary care must undertake a risk assessment to determine what resources are required in their local circumstances. Risk factors to consider are:
    • patient groups (e.g. adults, children,)
    • likelihood of cardiorespiratory arrest (more patients seen in out-of-hours home visits may be at higher risk than those seen in routine daytime visits)
    • training of staff likely to be available to assist at any specific location
    • the response time for the ambulance service to be able to provide more advanced equipment and life support skills
  5. This risk assessment should be overseen by a designated resuscitation lead. Expert advice should also be sought locally from those involved frequently in resuscitation (e.g. resuscitation officers, emergency physicians, ambulance services).
  6. Resuscitation equipment should be for single-patient use and latex-free, whenever possible. Where non-disposable equipment is used, a policy for decontamination between use in different patients must be available and followed.
  7. Personal protective equipment (e.g. gloves, aprons, eye protection) and sharps boxes must be available according to local policy.
  8. A reliable system of equipment checks and replacement must be in place to ensure that equipment and drugs are always available for use in a cardiorespiratory arrest. This process should be designated to named individuals, with reliable arrangements for cover in case of absence. The frequency of checks will depend upon local circumstances but should be at least weekly.
  9. The manufacturers’ instructions must be followed regarding the use, storage, servicing and expiry of equipment and drugs.
  10. The precise availability of equipment and drugs should be determined locally. The lists below include recommendations on when equipment and drugs should be available:
    • Immediate - available for use within the first minutes of cardiorespiratory arrest (i.e. at the start of resuscitation).
    • Accessible - available for prompt use when the need is determined by those attempting resuscitation.
  11. These lists are not exhaustive. Local experts should be consulted to ensure that appropriate equipment and drugs are available when they are needed, to enable provision of high-quality attempted resuscitation.
  12. These lists refer only to equipment for the management of cardiorespiratory arrest. All organisations providing primary care should have appropriate equipment and drugs for managing other life-threatening emergencies (e.g. anaphylaxis).

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3. Equipment and drug lists

                        

Primary Care - Minimum suggested equipment
    
  
 Item Suggested availability   Comments                 
Protective equipment - gloves,
aprons, eye protection 
Immediate  
Pocket mask (adult) with oxygen port
Immediate May be used inverted in infants 
Oxygen cylinder (with key where necessary) Immediate  
Oxygen tubing Immediate  
Automated external defibrillator (AED)  Immediate  Preferably with facilities for paediatric use as well as use in adults.

Type of AED and location determined by a local risk assessment. 

AEDs are not intended for use in infants (less than 12 months old) and this should be considered at risk assessment.
Adhesive defibrillator pads
Immediate
Spare set also recommended
Razor  Immediate  
Stethoscope  Immediate  
Absorbent towel
Immediate  To dry chest if necessary 


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Primary Care - For skill sets covering patients at increased risk of cardiorespiratory arrest    
   

(see Notes)     

 
AIRWAY AND BREATHING
Item Suggested availability
Comments
Protective equipment - gloves, aprons, eye protection
Immediate  
Pocket mask with oxygen port  Immediate  
Portable suction (battery or manual) with Yankauer sucker and soft suction catheters  Immediate Airway suction equipment. NPSA Signal. Reference number 1309. February 2011 
Oropharygeal airways sizes 0,1,2,3,4  Immediate  
Self-inflating bag with reservoir (adult) Immediate  
Self-inflating bag with reservoir (child)  Immediate  
Clear face masks sizes 0,1,2,3,4  Immediate  
Supraglottic airway device with syringes, lubrication, and ties/tapes/scissors as appropriate  Accessible Choice of device (e.g. laryngeal mask airway, i-gel®laryngeal tube) and size will depend on local policy and staff training
Oxygen cylinder (with key where necessary)  Immediate   
Oxygen tubing Immediate   
Stethoscope  Immediate  


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Primary Care - For skill sets covering patients at increased risk of cardiorespiratory arrest

(see Notes)

CIRCULATION
Item Suggested availability
Comments
Automated external defibrillator (AED) Immediate Preferably with facilities for paediatric use as well as use in adults.

Type of AED and locations determined by local risk assessment.

AEDs are not intended for use in infants (less than 12 months old) and this should be considered at risk assessment.
 
Adhesive defibrillator pads  Immediate  Spare set of pads also recommended. 
Razor  Immediate   
ECG electrodes  Accessible   May use AED pads or ECG electrodes with ECG monitor, according to local policy.
Intravenous cannulae (selection of sizes) and 2% chlorhexidine/alcohol wipes, tourniquets and cannula dressings Accessible  
Adhesive tape
Accessible  
Intravenous infusion set  Accessible  
Sodium chloride 0.9% (2 x 1000 ml)  Accessible   
Glucose 10% (500 ml)  Accessible  
Selection of needles and syringes  Accessible  
Intraosseous access device and / or needles suitable for infants, children and adults  Accessible  
IV extension set  Accessible Types of connectors, ports, and caps to be determined locally 
50 ml syringes x 2  Accessible  For intraosseous infusion
Adrenaline 1 mg (= 10 ml 1:10,000) as a prefilled syringe  Accessible Number of syringes required will depend on anticipated time until ambulance arrives: 1mg needed for each 4-5 min of CPR 
Algorithms, emergency drug doses, paediatric drug calculators  Immediate   According to local policy
 Sharps container Accessible  
 Scissors Accessible  
 Glucose monitor Accessible  

 

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Notes

  1. The list for those with enhanced skills or covering higher-risk patients, particularly, is for guidance only. Certain organisations may have practitioners whose skills can provide more advanced care than included on this list (tracheal intubation, arrhythmia management, other critical-care skills). Organisations employing those with such skills should ensure that provision is made so that these skills can be employed to ensure that patients receive optimal care.
  2. Similarly, some organisations may have staff who are not familiar with certain equipment in which case a local decision should be made as to whether training is increased to cover such skills or whether such equipment is not required.

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November 2013

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