‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: VOR Department Ne an en TO ALL HEALTH CARE SS ———_ Been SEVIS | PROVIDERS AND OTHER SSS CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy No: Pages: NAJRAN GENERAL o1 NEW - i HOSPITAL [Date Issued: Effective Dat Review Date: 08-11-1436H 08-12-1436H 08-12-1438H 1. PURPOSE: 41.1. To establish criteria for the initiation and termination of cardiopulmonary resuscitation (CPR) 1.2, To identify resources available to assist patient visitors/staff experiencing cardiopulmonary arrest. 1.3. To set forth the function and composition of the Hospital CPR team, and define coverage areas within the Hospital. 1.4. To ensure the efficiency and effective response to code blue call 2, DEFINITION: 2.1. Cardiopulmonary Resuscitation (CPR) - is an emergency medical procedure for a victim of cardiac and pulmonary arrest. 2.2. Code Blue - is the name given to an alert call for immediate assistance to save life of @ person who is found to be unresponsive with cardio pulmonary arrest. 2.3. Cardiac Arrest - is the sudden and complete loss of cardiac function. It may be due to ventricular fibrilation, asystole or electromechanical dissociation, 2.4, Respiratory Arrest - is the sudden and complete cessation of breathing. 2.8. Adult Code Blue - applies to all adults over 14 years old anywhere in the hospital 2.8. Pediatric Code Blue - applies to all children less than 14 years of age anywhere in the hospital inchiding Neonatal Intensive Care Unit (NICU) 2.7. Neonatal Resuscitation Program - an educational program that focuses on basic resuscitation skills for newly bom infants. 2.8, Basic Cardiac Life Support (BCLS) - This comprises: initial assessment, chest compression, airway maintenance, expired air ventilation (rescue breathing). Basic life Support implies that no equipment and no drugs are employed. 2.9. Advanced Cardiac Life Support (ACLS) - This comprises, in addition to Basic Life Support (BLS), usage of drugs and equipments during CPR including endotracheal tube, monitoring and DC shock 2.10. Witnessed Arrest - is one that is seen or heard by another person or an arrest that is monitored, 2.11. Assisted Ventilation - the act of inflating a patient's lungs by rescue breathing with or without a bag- mask device or any other mechanical device 2.12.Chest Compression (CC) - are performed by an individual during CPR in attempt to restore spontaneous circulation. 2.13, Drugs - refer to the delivery of any medication (by intravenous cannula, intraosseous needle, or tracheal tube) during the resuscitation event. 2.14, First Monitored Rhythm - is the first cardiac rhythm present when a monitor or defibrillator is attached toa patient after a cardiac arrest. [CPR POLICY MS-029 Page 1 of 11]VR... Department Name: TO ALL HEALTH CARE SEA sites CONCERNED PP ADMINISTRATIVE POI ‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: MEDICAL SERVICES PROVIDERS AND OTHER CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy No: Pages: NAJRAN GENERAL or ew 7 HOSPITAL Date Issue Effective Date: Review Date: 08-11-1436H 08-12-1436H 08-12-1438H 2.18.Return of Spontaneous Circulation (ROSC) - includes breathing (more than an occasional gasp), ‘coughing, or movement; may include evidence of palpable pulse or a measurable blood pressure. For the purposes of quality report - successful resuscitation or ROSC is defined as the restoration of a ‘spontaneous perfusing rhythm that results in more than an occasional gasp, fleeting palpated pulse, or arterial waveform, 2.16. Shockable/Non-shockable Rhythm - refers to the first monitored rhythm, which when analyzed by the Person interpreting the monitor/defibrillator, was found to be treatable by atternpted defibrillation ‘Shockable - Ventricular Fibrillation (VF) & pulseless ventricular tachycardia (VT); non-shockable either asystole or PEA 2.17.EMD - Electro Mechanical Dissociation: A condition at which there is cardiac rhythm seen on the monitor but no apical pulse could be felt and no heart sounds could be auscultated. It is also called as PEA. Pulseless electrical activity 2.18.Sustained ROSC - deemed to have occurred when chest compressions are not required for 20 Consecutive minutes and signs of circulation persist 2.18, MRP - Most Responsible Physician RESPONSIBILITY: 3.1. CPR Committee 3.2, Heads of Medical Staff Department 3.3, Medical Director POLICY: 4.1, The Hospital CPR Committee oversees all aspects of CPR, 4.2. The Medical Director works closely with the Nursing Director and other department head for CPR Team that will provide coverage for resuscitation at all imes (twenty-four hours round the clock). 4.3. CPR Is attempted on all persons experiencing cardiopulmonary arrest unless there is a valid “Physician's order to limit cardiopulmonary resuscitation’ in the medical record or a ‘Do Not ion" (DNR) decision has been made by the MRP in consultation with other staff and the Resusci patient/family and documented in the patient record, 4.4. All hospital staff should possess valid BCLS certificate to be able to take part in CPR. 4.5. Equipment should be available and operable at all imes to manage clinical emergencies requiring CPR. 4.6. The CPR Record should be kept in a designated location preferably on the top of the crash cart, so it ‘can be quickly found at the very beginning of resuscitation. [CPR POLICY MS-029) Page 2 of 14]N LIGY AND PROCEDURE ‘Applies 7 sh fa ee TO ALL HEALTH CARE = |_____ MEDICAL SERVICES| pROVIDERS AND OTHER SeaeesA [Titer CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy No: Pages: NAJRAN GENERAL O1 Hew - 44 HOSPITAL Date Issued: Effective Dati Review Date: | 08-11-1436H 08-12-1436H 08-12-1438H 4.7. CPR Teams: 4.7.4, Adult CPR Team: 4.7.1.1. Team Leader: Medical Specialist on duty will assume overall responsibilty for the direction of the code. (Certified with ACLS) 47.1.2. Members 47.41.24. Physician On Duty In Charge Of The Patient, 471.22. ICU Resident On Duty 47.1.2.3, Anesthesiologist On Call 47.1.2.4, Staff Nurse Assigned To The Patient 47.1.2.5. Head Nurse! Charge Nurse 4.7.1.2.6. ICU Nurse, If Possible 47.1.2.7. Nursing Supervisor On Duty 4.7.2. Pediatric CPR Team: 47.2.1. Team Leader: Pediatric Specialist On CalliDuty (Certified in PALS) 47.22. Members: 47.221. Pediatric Resident On Duty 4.1.2.2.2. Staff Nurse Assigned To The Patient 472.23. Head Nurse/Charge Nurse Of The Department 47.224, NICU Nurse, If Possible 47.225. _Nutsing Supervisor On Duty 4.8. Coverage Areas: 4.8.1, Adult CPR Team is responsible for responding to Female Ward, Male Ward, ER, Delivery Room, Operating Room, OB Gyne Ward, OPD (except Pedia) and ICU. 4.8.2. Pediatric CPR Team is responsible for responding to Pedia Ward, Nursery, NICU, Pedia ER, ‘Operating Room and Pedia OPD. 4.9. CPR Initiation and Termination of Resuscitation: 4.9.1. When a patient's condition warrants, CPR is initiated by a physician, nurse, or other qualified paramedical personnel (BCLS certified). 4.9.2, Resuscitation efforts are terminated after successful restoration of circulation and ventilation 4.9.3. In the event CPR efforts are unsuccessful, CPR is terminated after concurrence that the patient is unresponsive to all therapeutic efforts by the CPR Team. (Cer POLICY MS-025. Page Sof 11]‘APP ADMINISTRATIVE POLICY AND PROCEDURE aepres To: VR Depart amar ae TO ALL HEALTH CARE = ae fo MEDICAL SERVICES | PROVIDERS AND OTHER: SA ite CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Polley No: Replace Policy Noz Pages: NAJRAN GENERAL 04 NEW. a at HOSPITAL Date Teste Effective Dat Review Date: L 08-11-1436H 08-12-1436H 08-12-1438H 4.10, CPR Team Responsibilities: 4.10.1. Responsibilities of the Physician/Cardiologist (Team Leader): 4,10.1.1. Hisiher main task is to coordinate, direct and supervise the procedure. He/she should be thoroughly familiar with all basic and advanced cardiac lfe support procedures. 4.10.1.2. He will be the over all in-charge of the CPR procedure in Adult Patients, 4.10.13. He/she is responsible for: 4.10.1.3.1. Recognition of ECG patterns and application of defibrillator. 4.10.4.3.2. Indication and use of cardiac drugs. 4.10.1.3.3. Interpretation of Laboratory Data. 4.10.1.4. The physician with a nurse present at CPR should record all the drugs admi ered. He/she will also make a report of his/her part in the emergency and in the event of a mishap occurring, he/she will submit a full report to the CPR Committee 4.10.1.5. The decision whether to continue or not with CPR and also when to transfer the patient to the Intensive Care Unit will be made in conjunction with the physician in charge of the team, 4.10.1.6. When all the members of the team are available on the site he will supervise and lead the team. He will check the efficiency of the procedures e.g. ensure that cardiac massage is effective by checking the pulse, etc. 4,10.1.7. He/she may call the assistance of other specialist in concerned specialty, if needed, 4.10.2, Responsibilities of the Anesthesiologist 4.10.2.1. The duty anesthesiologist will attempt to get to the scene of emergency as quickly as possible 4.10,2.2, He/she will be expected to be conversant with all the steps of basic and advanced life support for adults, children and neonates, 4.10.2.3, In order to secure the airway and provide breathing support, he/she will be expected to know and be able to perform the following: 4.10.2.3.1. Avoid direct mouth to mouth and mouth to nose ventilation. 4.10.2.3.2. Use mouth to adjunct ventilation (pocket mask, S shaped airway, laryngeal mask airway, etc.) 4.10.2.3.3. Ventilate with a bag vaive mask 4.10.2.3.4. Endotracheal intubation within 30 seconds and ventilation (manual and mechanical) 4,10.2.4. Once the airway has been secured & checked for proper placement the anesthesiologist may delegate breathing support to the nurse or another physician so that he/she may then proceed to either aid in or actually perform intravenous cannulation for the purpose MS-029 Page 4 of 14]‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: Department Name: TO ALL HEALTH CARE MEDICAL SERVICES: PROVIDERS AND OTHER, Title: CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy N Pages: NAJRAN GENERAL i] new a HOSPITAL Date Issued: Effective Dat Review Date: 08-11-1436H 08-12-1436H 08-12-1438 4.10.3.2.1 4.10.3.2.2. 4.10.3.2.3. 4.10.3.2.4. 4.10.3.2.5. 4.10.3.2.6. 4.10.3.2.7. 4.10.3.2.8, 4.10.3.2.9. 4.10.3.2.10. 4.10.3.2.11 4.10.3.2.12 of administering drugs and fluids or taking blood samples, and the intra arterial cannulation for blood gas analysis. 4.10.25, In the event that the anesthesiologist has to initiate appropriate interventions in the absence of other physicians (e.9., defibrillation and administering of appropriate drugs), helshe will be expected to do so. 4.10.26. The senior anesthesiologist on call will be contacted for advice in case of any problems encountered during CPR. 4.10.3, Responsibilities of the Pediatrician: 4.10.3.1, In case of pediatric arrest, the duty pediatrician will be the overall in-charge of the CPR procedures in the pediatric or neonatal ward or intensive care. His/her main task as a team leader is to coordinate and supervise the entire resuscitation procedure. 4.10.3.2. Helshe is expected to be thoroughly familiar with all BCLS and ACLS procedures. The team leader is responsible for all of the following Recognition of ECG pattems. Indication and use of drugs. Safe DC defibrillation Order an LV. line Temporary pacing Interpretation of laboratory data, Monitor performance of external cardiac massage. Order ventilation (mouth to mouth with the use of bag valve mask, endotracheal intubation, etc.) He/she should be familiar with the indications of successful CPR and reports honestly in the cardiac arrest chart all relevant and pertinent data regarding the procedure. When all the members of the team are available at the site he/she will supervise and lead the team. He/she will order which drugs or procedures are to be administered or performed and are overall in-charge of the procedures. He/she checks the efficiency of the procedures e.g, ensures that cardiac massage is properly performed by checking the pulse ete. ‘The leader of the team is responsible for discussing with his/her colleagues the need for and seeking advice from other departments, to decide when to stop CPR ot admit to ICU He/she must maintain current certification in Basic and Advanced Cardiac Life Support or Pediatric Advanced Life Support (PALS). Certification in BCLS, ACLS and PALS must be renewed every two years | [opR POLICY MS-029 Page 5 of 11}‘APP ADMINISTRATIVE POLICY AND PROCEDURE NAJRAN Hos! Applies To: Department Name: TO ALL HEALTH CARE MEDICAL SERVICES PROVIDERS AND OTHER Ti CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy Noz Replace Policy No: Pages GENERAL ul a a PITAL, Date Issued: Effective Dat Review Date: 08-11-1436H 08-12-1436H 08-12-1438H 4.10.4, Responsibilities of Physicians other than Anesthesiologist or Pediatrician: 4.10.4.1. In the event that anesthesiologist/pediatrician is not available the following will obtain Team Leader responsibilities (preferably ACLS certified) (see 24-hour rota for CPR team) 4.10.4.1.1, ICU Resident On-Duty 4.10.4.1.2, Most Senior ER Resident 4.10.42. Most Responsible Physician (MRP) or the Departmental Resident 4.10.42.1. Follow-up for further management 4.10.4.2.2, Consults ICU team for ICU admission/ further management. 4.10.4.2.3. Notifies the family the outcome of CPR and current status of the patient. 4.10.5. Responsibility of the staff nurselfirst responder: 4.10.5.1. On discovering the arrest, the first person will become the first rescuer immediately initiating the code blue as instructed, and will remain with the victim and starts resuscitation, 4.10.5.2. Assessment Determine unresponsiveness; tap, shake shoulders and shout: (Are you 0.K.) 4.10.5.3. Calll for help and activate code blue. Ask his/ her colleague to call paging system (Telephone No. 342) to page Code Blue. 4.10.6.4, Follow CAB 4.10.5.4.1. = CIRCULATION 4.10.5.4.1.1. Assessment: Determine pulselessness 4.10.5.4.1.2. Begin chest compression at rate of more than 100 per minute 4.10.5.4.2, A-AIRWAY 410.5.4.2.1, Position the victim 410.5.4.2.2, Open the ainway 4.10.5.4.3, B-BREATHING 4.10.5.4.3.1. Assessment- Determine breathlessness 4.10.5.4.3.2. Give two rescue breaths (if breathing is absent or patient is gasping) 4.10.5.5. Continue one rescuer CPR until 2nd rescuer retuins and is ready to assist in two rescuers CPR. 4.10.6. Responsibility of the Ward Head NurseiCharge Nurse 4.10.6.1. Responds immediately to the Code Blue call 4.10.6.2. He/she is responsible for documenting all events of the emergency in the cardiac arrest immediately and accurately and later chart in the patient's record. These includes the following: (GPR POLICY MS-029 Page 6 of 11]‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: aE TO ALL HEALTH CARE % st MEDICAL SERVICES __| PROVIDERS AND OTHER eA ite: CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy No: Pages: NAJRAN GENERAL of al 5 7 HOSPITAL Date issuci Effective Date: Review Dat | 08-11-1436H 08-12-1436 08-12-1438H ] 4.10.6.2.1. Allrelevant data of the patient's previous condition 410.6.2.2. Time that the arrest was noted and who initiated the call 4.10.6.2.3. Make sure that code blue call has been activated and note the times of arrival of the responders, at the site of emergency 4.10.6.2.4, Patient events, treatments, responses to treatments and other pertinent data 4.10.6.2.5, Medications, including I.V. fluids and responses. 4106.26. DC shocks. 4.10.7. Responsibility of Nurse Supervisor 4.1.7.1. Responds immediately to the code call 4.10.7.2. Supervises the overall management of an arrest situation. 4.10.7.3, Ensures all team members have arrived or takes appropriate action to summon any member not responding. 4.10.7.4, Ensures crash cart arrival and dispatches for any other supplies urgently required. 4.1.7.5. Maintains crowd control, dismisses those that are not required for other duties and also unwanted guests. 4.10.76. The nursing supervisor on duty will be responsible to delegate the responsibility to the available nurses on duty in case of shortage. 4.10.7.7. Completes the documentation of CPR Record and CPR Quality Review accurately in blue ink and retums to CPR Committee Chairman by the end of the shit 4.11. Pharmacist will replenish the drugs used in the crash cart after completion of the code. 4.12, The Head Nurse/Charge Nurse of the area where the code occurred is to review the CPR Record form and rhythm strips for completeness before sending the form and strips. 4.13. The team leader must sign the CPR Record form for treatmentinterventions given in place of writing physician's orders. 4.14, The team must review the arrest after the code to determine completeness, accuracy and evaluation of code performance. 4.15. The CPR Record form's original copy will be attached in patient's file and a copy plus CPR Quality Review will be given to CPR committee thru the CPR committee chaltman, and to Quality Department. 4.46. The 24-hour rota for CPR team is prepared and coordinated by Medical Services and Nursing Services. | This will be posted in all. departments. 4.17. Mock Codes specific to each area as designed by Medical Director, Nursing Director in collaboration with the Education Department will be coordinated every 3 months (quarterly). Mock Codes are designed to train staff in the essential activities required during initial phase of resuscitation. Staff Participation requirements are determined by each staff member's patient care responsibilities [CPR POLICY MS-028, Page 7 of 11FOL Applies To: Rue Department Na EDICAL SERVICES FOTO Mio eh = |___ MEDICAL SERVICES _| PROVIDERS AND OTHER SA fie CONCERNED = CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy Nor Page: NAJRAN GENERAL rice NEW HOSPITAL Date Issued: Effective Date: Review Da 08-11-1436H 08-12-1436H. 08-12-1438H. 4.18. Checking of the crash cart (emergency cart): 4.18.1, The crash cart should be checked daily in every shift and documented in the crash cart checklist the signature of the staff that checked, date and time. Defibrillator should be checked daily in ‘every shift for functioning. Oxygen tank in the crash cart should always be checked to determine the oxygen level 4.18.2. The Head Nurse should retain the checkiist for a minimum of 3 months. 4.19. CPR Committee 4.19.1, Ensure that all codes are discussed in CPR committee and submit discussions to the Medical Director, Quality Management Director and Hospital Director. 4.19.2, Ensure high standards of resuscitation and emergency intensive therapy. 4.19.3, Periodic review ofall records of all cardiac arrest charts. 4.19.4, Review of the policy and procedure. The committee reports to the Hospital director thru Medical Director every month including statistical analysis of CPR, problems, and recommendations. 4.19.5. The committee should meet regularly every month. 4.19.6. Ensure that all the doctors, staff nurses, pharmacists and technicians are BCLS Certified by the ‘Saudi Heart Association and updated every two years. 4.19.7. Recommends doctors and staff nurses who requires advance cardiac support training 4.20, Resuscitation procedure should be followed in line with the current and updated guidelines, training and the algorithms, provided by Saudi Heert Association/American Heart Association 4.21. Only the team leader will terminate the procedure based on cardiac unresponsiveness to adequately performed CPR. 4.22. Nursing services will maintain and implement a policy for regular training of the nursing staff for using equipments (as there are continuously new staff and new equipments). 4.23.Victims arrested at any departmentfunit should be resuscitated in their location, Time should not be wasted in transferring them to the ICU. The nearest crash cart should be brought to the area immediately. 4.24,The security person in the area (or designated by Security Director) is responsible for controling crowds, keeping all visitors away from the code areas, facilitating for the CPR team, dealing with relatives and remaining in the area until relieved of duty by the leader. 4.25. All CPR team members resuscitating a patient shall follow the Infection Control Standard Precaution 5. PROCEDURI 5.1. The person nearest to the patient, any hospital staff (if BCLS certified) will initiate the basic life support 6.2. The first responder will proceed to CAB assessment and initiate CPR (until the CPR Team arrive), call for help, ask colleague to call paging system (Telephone No. 342) to page Code Blue. CPR POLICY MS-029 __ Page 8 of 17‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: VK Department Ne cal ae ‘TO ALL HEALTH CARE Se PROVIDERS AND OTHER | Sata fie CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH eee Poliey No: [Replace Policy No: Pages: NAJRAN GENERAL of NEW HOSPITAL Date lesued: Effective Dato 08-11-1436H 08-12-1436 5.3. The colleague (doctor or nurse) will dial 342 providing the following information slowly and clearly and repeating the information, if necessary: 5.3.4, Indicate whether the patient is pediatric or adult 6.3.2. State the nature of the emergency-Code blue 5.3.3, Location and room number 5.4. Code Blue Activation: the receiver will initiate a sequence of events as follows: 5.4.1, Activation of the Code Blue team, 5.4.2. Immediate overhead announcement in English repeated three times clearly. Example “Attention (Pediatric or Adult) Code Blue in Female Ward Room 6” 6.5. On the arrival of each of the member of the code blue team, the member will introduce themselves by stating their name and the job title. Each member will wear the identification card of their job title and their position in the team 5.6. Upon arrival of the team the patient will be rapidly assessed again and confirm the arrest. Every member of the team will take his/her responsibilty according to the policy and initiating ACLS protocols ensuring that there is only one team leader. 5.7. Documentation and Quality Control 5.7.1. CPR Record will be completed and served as the documentation of the event, It will be fulfiled by the Head Nurse / Charge Nurse, signed by the Code Blue Team members. (This will become a permanent part of the patient's medical record) 5.8, Early Defibrillation and Monitor- Defibrillation Use: 5.8.1. For both defibrillation and cardioversion, the physician performing the procedure or the nurse assisting, documents in the patient's progress notes the pre-shock rhythm. The energy level and ost-shock rhythm. The preferred documentation is with rhythm strip and a corresponding written note. 5.8.2. Document the following in the patients progress notes 5.8.2.1. Pre arrest condition of the patient. 5.8.2.2. IF CPR was performed. 5.8.2.3. How many times the AED shock given to the patient “6.8.2.4, Patient outcome 5.9. After each code, the CPR Record should be reviewed for completeness and process of care through debriefing. Feedback must be given to the providers for a job well done or improvement needed. Evaluations are as follows: 5.9.1. CPR Quality 5.9.2. Standard precautions 5.9.3. Documentation 5.9.4. Aerting Hospital Wide Resuscitation response [CPR POLICY S097 Page 9 of 11)[ Vo Department Name: TO ALL HEALTH CARE fo OO ee MEDICAL SERVICES ‘APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: PROVIDERS AND OTHER SeewA = [iter CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy No: Replace Policy No: Pages: NAJRAN GENERAL at NEW. 1 HOSPITAL Date issue Effective Dat Review Date: 08-11-1436H 08-12-1436H 08-12-1438H 6.9.5. Airway Management 5.9.6. Vascular Access 5.9.7. Chest Compression 5.9.8, Defibrillations 5.9.9. Medication 5.9.10. Leadership 6.9.11. Protocol Deviation 5.9.12, Equipment 5.10. The, Quality Department shall secure all CPR Record and CPR Quality Review, trend, aggregate and Feport to CPR committee monthly, quarterly and periodically (annual report) showing their processes ‘and outcomes compare to like institution (benchmarking). 5.11. Systems of care should change and committee's recommendations (CPR committee) must be based on concerns reported so that staffs see their input has been used to improve the quality care. FORMS & EQUIPMENT: 6.1. Forms’ 6.1.1. CPR Record (MS-028) APP-FORM 1A&B 6.1.2. CPR Quality Review (MS-029) APP-FORM 2 6.2. Equipment 6.2.1. Oxygen 6.2.2. Suction set supply 6.2.3, Bag valve mask with tubes 6.2.4. Crash cart with CPR medication, intubation and venous access equipments, defiorillator and IV fluids, 6.2.5. Central line kit 6.26. Stethoscope REFERENCES: 7.4. Resuscitation Policy and Procedure, East Lincolnshire Primary Care Trust, National Health Services, UK. Accessed on 20.02.2009. 7.2, American Heart Association guidelines for CPR and ECC 2010 Hazinski MF, Nolan JP Billi JE et. al Part 1: Executive summary 2010 Intemational Consensus on Cardiopulmonary Resuscitation and Emergency cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with treatment Recommendations circulations in press 7.3. CBAHI Standards- MS No. 29 Sample Tool 7.4, Saudi Heart Association CPR Manual 7.5. Cardio Pulmonary Resuscitation Policy, Sharourah General Hospital, KSA [CPR POLICY MS=025 Page 10 of 11 |APP ADMINISTRATIVE POLICY AND PROCEDURE ‘Applies To: en Department Name: TO ALL HEALTH CARE. || eR MEDICAL SERVICES PROVIDERS AND OTHER SS fie: CONCERNED CARDIO PULMONARY RESUSCITATION DEPARTMENTS IN NGH Policy Nor Replace Policy Nor Page: NAJRAN GENERAL 1 NEW a HOSPITAL Date Issued: Effective Date: 08-11-1436H 08-12-1436 08-12-1438H 8. APPROVAL: NAME POSITION SIGNATURE DATE pee ELAINE F. SOGRADIEL A. Prepared by: Quality Management Staff fer | gee MR. KHALID 8.2, Reviewed by: Quality Management Director wfhgae a DR. ABDULMONEM AL SHAYEB 6 Medical Services Director WX8a3 8.3. Approved by: (MR, IBRAHIM HAMAD MANA AL AMER Hospital Director 9. CONCERNED DEPARTMENT: Name And Title Signature Dato DR. ABDULMONEM AL SHAYEB \wae®s Medical Stat WS MS. FATMA MAHDI RASHED Nursing Services Voll iyae MR. SAEED AL SOGOOR Pharmacy . HASSAN ALI FARE: Infection Control And Public Heatth eniEEEssninsnsntnn nin nnssons nso nsssEen nneSSESSSSSREEESEREES | aK MR. ALL AL SEDRAN Se ve Facility Management Safety | [EPRPOLICY MS-028 Page tof 111 LETHAL ARRYTHMIAS MEDICAL RECORD NO. NAME: AGE SEX: NATIONALITY: KINGDOM OF SAUDI ARABIA 1" dopomior Savona CONSULTANT IN CHARGE: NAJRAN HEALTH AFFAIRS | DEPARTMENT: UNIT: NAJRAN GENERAL HOSPITAL NAJRAN. KSA CPR RECORD DATE OF ADMISSION: PROVISIONAL DIAGNOSIS: DATE OF EVENT: LOCATION: GI WITNESSED? _CIYES ONO UNKNOWN BY: EVENT VARIABLES sBRIEF HISTORY: 2RESUSCITATION ATTEMPTED | sINITIAL CONDITION BEFORE CPR TEAM? CONSCIOUS? DYES ONO IVACCESS. CONFIRMED? DYES DINO BY:CAUSCULTATION CEXHALED CO, D CHEST PAIN YES (CHECK ALLUSED) | BREATHING? DYES DINO TRAUMA (CHEST COMPRESSION | IF YES, CISPONTANEOUS D SUDDEN CARDIAC ARREST | DEFIBRILLATION DIAGONAL UNKNOWN O_AIRMAY TIASSISTED OTHER ONO PULSE? YES ONO (OUT OF HOSPITAL PUPILS REACTIVE? CYES ONO CNA FORW.2 age eft