The resuscitation officer

The resuscitation officer should be an approved instructor in advanced life support, often also in paediatric advanced life support and sometimes in advanced trauma life support. The background of resuscitation officers is usually that of a nurse with several years' experience in a critical care unit, an operating department assistant, or a very experienced ambulance paramedic. The resuscitation officer is directly responsible to the chair of the resuscitation committee and receives full backing in carrying out the role as defined by that committee. It is essential that a dedicated resuscitation training room is available and that adequate secretarial help, a computer, telephone, fax machine, and office space are provided to enable the resuscitation officer to work efficiently. As well as conducting the in-hospital audit of resuscitation, he or she should be encouraged to undertake research studies to further their career development.

Doctors, nurses, and managers do not always recognise the crucial importance of having a resuscitation officer, especially when funding has been a major issue. Training should be mandatory for all staff undertaking general medical care. It is likely that many specialties will require formal training in cardiopulmonary resuscitation before a certificate of accreditation is granted in that specialty.

It is advisable that the recommendations of the Royal College of Physicians' report and the recommendations of the

The resuscitation committee

Cardiology or general medicine Anaesthesia and critical care Emergency medicine Paediatrics

• Resuscitation officer

• Nursing staff representative

• Pharmacist

• Administrative and support staff representative—for example, porters

• Telephonists' representative

The resuscitation committee should receive a regular audit of resuscitation attempts, hold audit meetings, and take remedial action if it seems necessary. Resuscitation provision and performance should be regularly reviewed as part of the clinical governance process

Chair of the resuscitation committee

Committee

Resuscitation officer

Training

Training room and equipment

Administration

Secretarial support

Resuscitation team structure

Resuscitation Council (UK) should be implemented in full in all hospitals. All hospitals should have a unique telephone number to be used in case of suspected cardiac arrest. It would be helpful if hospitals standardised this number (222 or 2222) so that staff moving from hospital to hospital do not have to learn a new number each time they move. This emergency number should be displayed prominently on every telephone. When the number is dialled an audible alarm should be sounded in the telephone room of the hospital, giving the call equal priority with a fire alarm call. Because the person instigating the call may not know exactly what location they are calling from, the telephone should indicate this—for example, "cardiac arrest, Jenner Hoskin ward, third floor." By pressing a single button in the telephone room all the cardiac arrest bleeps should be activated, indicating a cardiac arrest and its location.

The hospital resuscitation committee should determine the composition of the cardiac arrest team. In multistorey hospitals those carrying the cardiac bleep must have an override facility to commandeer the lifts.

The resuscitation officer must ensure that after any resuscitation attempt, the necessary documentation is accurately completed in "Utstein format." Nursing staff should check and restock the resuscitation trolley after every resuscitation attempt.

It is essential that the senior doctor and nurse at the cardiac arrest should debrief the team, whether resuscitation has been successful or not. Problems should be discussed frankly. If any member of staff is especially distressed then a confidential counselling facility should be made available through the occupational health or psychological medicine department.

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