Resuscitation Equipment [QSI Ref: XR-401]

Availability and acceptability of resuscitation equipment.

Patients attending the Department of Clinical Radiology may require resuscitation or life support at any time, either because of deterioration of their clinical condition or from a complication following an investigation / procedure (e.g. reaction to iodinated contrast medium). The Resuscitation Council (UK) points out that sudden cardiac arrest is a leading cause of death in Europe, affecting about 700,000 individuals a year. The scientific evidence to support early defibrillation is overwhelming; the delay from collapse to delivery of the first shock is the single most important determinant of survival. The chances of successful defibrillation decline at a rate of 7-10% with each minute of delay [6], hence the need for all departments and all members of departments to have access to readily available defibrillators and resuscitation equipment. All clinical areas within the department should be adequately equipped to deal with these events. Regular audits of resuscitation equipment represents sensible risk management.

The standard: 

A locally agreed standard based on The Royal College of Radiologists guidelines, The Department of Clinical Radiology should at all times have:

• Appropriate and functional emergency equipment available, including an automated external defibrillator, Ambu bag and an appropriate selection of paediatric / adult airways, endotracheal tubes and/or laryngeal mask airways

• A supply of emergency drugs, in date and approved by both the Clinical Head of Service and a designated anaesthetist / hospital resuscitation committee. The drugs box should contain an agreed range of drugs and equipment as per local policy, such as in Annex 1 [6].

Target: 

100%

Indicators: 

Compliance with the standard on the day of the audit.

Data items to be collected: 

On the day of the audit, record whether:

• All emergency equipment is present and functional

• Emergency equipment is well maintained and in a safe condition

• All emergency drugs are present and in date

• Drugs correspond to the list approved by the designated anaesthetist [1,6]

• Written records with regard to routine checking are available for inspection and kept in good order

Suggested number: 

Carry out the whole audit on one day

The day should be chosen at random (a blitz audit)

• Designate a named consultant anaesthetist to have responsibility within the Department of Clinical Radiology, who should list in detail all appropriate resuscitation drugs to have available

• Introduce a formal nursing rota for checking of resuscitation equipment and drugs - keep written records

• Update the defibrillation equipment if the anaesthetist deems necessary (e.g. automated external defibrillator instead of manual)

• Ask the Hospital Pharmacy to perform regular checks on resuscitation drugs, checking their date and their condition

• Provide identical equipment at suitable positions if the department is multi-storey

• Re-site resuscitation equipment if accessibility is considered inadequate. Seek advice from the Hospital Resuscitation Training Officer (RTO) on where to locate the equipment within the department

• Ascertain that clear lines of responsibility and accountability are understood in regard to regular checking and the action taken on any deficiencies

Scrutiny and completion of an inspection proforma

The inspection to be carried out by Nursing staff, the RTO or Consultant Anaesthetist (3–4 hours)

1. 2016 RANZCR Iodinated Contrast Guidelines https://www.ranzcr.com/search/ranzcr-iodinated-contrast-guidelines

2. Royal College of Anaesthetists and Royal College of Radiologists. Sedation and Anaesthesia in Radiology. Report of a Joint Working Party. London: RCR, 1992.

3. Royal College of Nursing. Standards of Care: Radiology Nursing (Topic 4: Safety). London: RCN, 1993.

4. Royal College of Radiologists. Safe Sedation, Analgesia and Anaesthesia within the Radiology Department 2e. London RCR, 2018. https://www.rcr.ac.uk/sites/default/files/audit_template/bfcr18_safe_sedation.pdf

5. Royal College of Radiologists. Standards for intravenous contrast agent administration to adult patients. 2nd edition. RCR, 2010. https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/BFCR%2810%294_Stand_contrast.pdf

6. Resuscitation Council UK Quality Standards: Acute care equipment and drug lists originally published November 2013. Last updated May 2020. https://www.resus.org.uk/library/quality-standards-cpr/acute-care-equipment-and-drug-lists

Dr M O’Driscoll, Dr D Remedios and Dr E Elson, updated by Dr D Remedios