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ACCCN Ltd position statement on adult and paediatric resuscitation by nurses
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AUSTRALIAN CRITICAL CARE
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ACCCN h Z l " Q & i t i ~statemerA on adult and paediatric resuscitation by numesh. . --
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ACCCN Ltd Advanced Life Support Subcommittee
ACCCN Ltd recommends that all nurses receive basic life support (BLS) training as a component of their entry-level qualification, and that they be responsible for maintaining their competence in BLS o n at least an annual basis. ACCCN Ltd further recommends that, where semi-automatic defibrillators are accessible, competence in their use should be considered a feature of BLS training and practice. In addition, ACCCN Ltd recommends that registered nurses working in critical care environments in which patients are at risk of sudden, life-threatening emergencies as a result of airway, breathing and/or circulatory conditions should become competent in the provision of advanced life support (ALS), while registered nurses working in areas in which children are at risk of sudden and life-threatening emergencies should become competent in the provision of paediatric advanced life support (PALS). Health-care agencies that provide critical care facilities should define the registered nurse's role in initiating and maintaining ALS skills with or without a medical officer present. These skills may include the following.
ALS Arrhythmia recognition Defibrillation Insertion of intravenous cannulae Administration of first-line pharmacological agents Advanced airway management, including intubation Transcutaneous pacing Post-resuscitation management Patient transport
PALS Advanced airway management Use of age-appropriate equipment Administration of first-line pharmacological agents and fluid therapy according to weight Alternative access to circulation Defibrillation Post-resuscitation management Patient transport Where registered nurses work in isolation and are primarily responsible for the health care and management of communities, competency in BLS, ALS and PALS is recommended. The registered nurse should be supported by appropriate educational guidelines, protocols, communication and ALS equipment, in order to manage patients with life-threatening emergencies until support services can arrive. As with BLS, ACCCN Ltd recommends that registered nurses formally reassess their competency in ALS/PALS on at least an annual basis. Informal, frequent self-assessments between formal assessments, either through work performance in clinical sessions or simulation exercises, are also advisable. In keeping with its status as a member of the Australian Resuscitation Council (ARC), ACCCN Ltd promotes and supports the policies and guidelines of the ARC.
Following these national
guidelines ensures a consistent approach to life-threatening situations and thus the best possible outcome for patients.
ADVANCED LIFE SUPPORT CURRICULUM REVIEW SERVICE
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ACCCN Ltd offers an advanced life support (ALS) curriculum review service to organisations that conduct ALS courses. ACCCN Ltd, as a member of the Australian Resuscitation Council (ARC), fully supports current ARC policy statements as the most appropriate guidelines for the practice of ALS in Australia. The ACCCN Ltd curriculum review service intends to assess course curricula for consistency with the ACCCN Ltd ALS Curriculum Guide and ARC ALS guidelines (current at the time of review). The ALS curriculum review service is administered through the ALS committee of ACCCN Ltd, which contracts an independent external reviewer to assess whether curricula submitted for review are consistent with the ACCCN Ltd curriculum guide.
Benefits The curriculum review service can create greater consistency in ALS course content at a national level. It will ensure that an ALS course curriculum is consistent with ACCCN Ltd guidelines and that its content is consistent with ARC guidelines. There are benefits for ACCCN Ltd in encouraging course providers to actively promote their successful outcome from a review, as the review will thereby gain a reputation as a valuable quality standard sought after by all organisations offering ALS education.
VOLUME 13
NUMBER 1
MARCH 2000
A
AUSTRALIAN CRITICAL CARE
P
ACCCN h Z l " Q & i t i ~statemerA on adult and paediatric resuscitation by numesh. . --
-7
-
. ' Y ' ='
ACCCN Ltd Advanced Life Support Subcommittee
ACCCN Ltd recommends that all nurses receive basic life support (BLS) training as a component of their entry-level qualification, and that they be responsible for maintaining their competence in BLS o n at least an annual basis. ACCCN Ltd further recommends that, where semi-automatic defibrillators are accessible, competence in their use should be considered a feature of BLS training and practice. In addition, ACCCN Ltd recommends that registered nurses working in critical care environments in which patients are at risk of sudden, life-threatening emergencies as a result of airway, breathing and/or circulatory conditions should become competent in the provision of advanced life support (ALS), while registered nurses working in areas in which children are at risk of sudden and life-threatening emergencies should become competent in the provision of paediatric advanced life support (PALS). Health-care agencies that provide critical care facilities should define the registered nurse's role in initiating and maintaining ALS skills with or without a medical officer present. These skills may include the following.
ALS Arrhythmia recognition Defibrillation Insertion of intravenous cannulae Administration of first-line pharmacological agents Advanced airway management, including intubation Transcutaneous pacing Post-resuscitation management Patient transport
PALS Advanced airway management Use of age-appropriate equipment Administration of first-line pharmacological agents and fluid therapy according to weight Alternative access to circulation Defibrillation Post-resuscitation management Patient transport Where registered nurses work in isolation and are primarily responsible for the health care and management of communities, competency in BLS, ALS and PALS is recommended. The registered nurse should be supported by appropriate educational guidelines, protocols, communication and ALS equipment, in order to manage patients with life-threatening emergencies until support services can arrive. As with BLS, ACCCN Ltd recommends that registered nurses formally reassess their competency in ALS/PALS on at least an annual basis. Informal, frequent self-assessments between formal assessments, either through work performance in clinical sessions or simulation exercises, are also advisable. In keeping with its status as a member of the Australian Resuscitation Council (ARC), ACCCN Ltd promotes and supports the policies and guidelines of the ARC.
Following these national
guidelines ensures a consistent approach to life-threatening situations and thus the best possible outcome for patients.
ADVANCED LIFE SUPPORT CURRICULUM REVIEW SERVICE
&$j-
zi
4F
iP
J
.*
ACCCN Ltd offers an advanced life support (ALS) curriculum review service to organisations that conduct ALS courses. ACCCN Ltd, as a member of the Australian Resuscitation Council (ARC), fully supports current ARC policy statements as the most appropriate guidelines for the practice of ALS in Australia. The ACCCN Ltd curriculum review service intends to assess course curricula for consistency with the ACCCN Ltd ALS Curriculum Guide and ARC ALS guidelines (current at the time of review). The ALS curriculum review service is administered through the ALS committee of ACCCN Ltd, which contracts an independent external reviewer to assess whether curricula submitted for review are consistent with the ACCCN Ltd curriculum guide.
Benefits The curriculum review service can create greater consistency in ALS course content at a national level. It will ensure that an ALS course curriculum is consistent with ACCCN Ltd guidelines and that its content is consistent with ARC guidelines. There are benefits for ACCCN Ltd in encouraging course providers to actively promote their successful outcome from a review, as the review will thereby gain a reputation as a valuable quality standard sought after by all organisations offering ALS education.
VOLUME 13
NUMBER 1
MARCH 2000
A