Feedback on mock resuscitations

* Mandate of the resuscitation committee to periodically evaluate mock resuscitations in the wards.

Period: 18/09/13 to 19/09/13

Participating wards: A, B, F, H, L, M

Tool used: Netcare Mock Resuscitation Form

Procedure HOD and Unit manager &/ shift leader informed beforehand for logistical arrangements. Emergency alarm sounded at patients bedside. First responder informed that patient is not breathing. The resuscitation observed and checklist completed. Discussion with participants. Copy of assessment form given to participants.

Points of interest by ward Ward A (female surgical) Quick response, well-coordinated resuscitation Senior nurse led the team with good communication and team work Time and record keeper present Knowledge of code blue alarm and team adequate Brought emergency trolley to scene Doctor responded to alarm, arrived and left without asking

Ward B (male surgical) Emergency alarm on patients bedside not working Poor initial response to first responders cry for help

Only two participants carried out CPR, the rest stood and watched Poor quality CPR with inability to use AED

Ward F (male medical) Knowledge of code blue alarm and team lacking Emergency trolley not brought to scene, instead items picked out one by one from trolley to bedside Initial response slow, time to initiate CPR after recognition of arrest long Poor team work Incorrect use of AED Doctor present but not skilled in bls

Ward H (Orthopedic) Quick response by first responder Team led by senior nurse However, help delayed to come Emergency trolley arrived at scene Resusc board used correctly Doctor called to assist Rest of the team not aware of location of code blue alarm Some members not participating but watching

Ward L (Post-natal) Quick initial response but only two participants By and large inadequate CPR without use of emergency trolley, no activation of code blue, inability to use AED

Ward M (paediatric surgery) 100% non-compliant No clinical personnel available in the unit for over 10 minutes Lack of BLS skills

Areas identified that need improvement: Activation of code blue system Only 1 of the 6 wards had adequate knowledge

 Use of emergency trolley 3 out of 6 wards brought the trolley to the bedside

Timing of chest compressions after recognition of arrest Only 1 ward started compressions within 10 seconds

Use of resusc board Only 1 ward made use of the board

Airway and breathing Uniformly this component of CPR was done poorly None of the wards pulled the bed away from the wall and removed the headboard None connected oxygen to the BVM

Correct use of AED Still lacking in more than half of the participating wards

Other discussion points Pulse check Frequency of environmental check Participation of non-clinical staff