A resuscitator is a medical device that uses positive pressure to inflate the lungs of a person, who’s unconscious and has stopped breathing, to keep them oxygenated and alive. There are a wide variety of resuscitation equipment and accessories available in the NZ market today, all of which are designed to make it easier to administer oxygen to a patient.

They are designed to provide emergency care for patients who have suffered serious injuries, have fallen unconscious or have a critical or life-threatening illness, all of which call for immediate medical care and monitoring.

Resuscitation equipment

Resuscitation equipment should be easy to use and maintain because it will be used only a few times a year. In addition to receiving professional-level training (via only a well-reviewed institute providing resuscitation courses in NZ), staff must also know where to find the equipment when needed, even at the 11th hour!

Each practice must have a designated person who’s in charge of checking the operational readiness of all resuscitation drugs and equipment, including the automated external defibrillator (AED), on a regular basis (at least once per week).

In the same way that pharmaceuticals have a limited shelf life, single-use items such as adhesive electrodes have a shelf life as well, and if they remain unused for an extended period of time, they will eventually need to be replaced.

Defibrillators:

AEDs that were designed for modern-day first responders are usually light-weight, portable, compact, reasonably priced, and simple to operate. The majority of these machines, that are currently available in the NZ market, perform self-checks and provide feedback regarding the need for performing maintenance or replacing batteries.

Defibrillation, however, is pretty time-sensitive, with the likelihood of a successful resuscitation decreasing by ~10% for every 1 minute that the procedure is delayed. When practices have their own defibrillator (rather than depending on the ambulance service to provide one), attempts at defibrillation will typically be carried out earlier.

Every healthcare practice should be equipped with automated external defibrillator (AED) equipment, and there need to be suitable arrangements in place to make sure that it is readily available whenever it’s needed. In the same vein, there should always be someone available who’s received professional training via resuscitation courses in NZ and is fully capable of using the AED whenever there may be patients present in the building.

People who provide medical coverage outside of normal practice hours should also have access to an automated external defibrillator (AED), regardless of whether they do so as individuals, in Primary Care Centres or community hospitals, as part of a deputising service, co-operative, or any other type of similar out-of-hours service. Other fundamental pieces of resuscitation gear, such as those used for managing the airway and dispensing medications, should also be easily accessible.

Therefore, an automated external defibrillator (AED) must always be accessible wherever and whenever sick patients are seen. If there is a reasonable possibility that there will be a cardiac or respiratory arrest, it is to be brought into the operating room and then transported to patients who are being seen in other areas. After using the machine, the instructions provided by the manufacturer should be adhered to so that it can be brought back to a state of readiness with as little lag time as possible.

Airway management

The minimum standard required is the expired air ventilation, also known as Expired Air Resuscitation (EAR)*, which should be carried out using a pocket mask with a one-way valve to stop patient secretions from getting to the rescuer. Other simple airway barrier devices, such as face masks and snorkels, do not allow ventilation to be performed as effectively as the pocket mask does. Many of these devices provide a significant amount of resistance to lung inflation.

If necessary, one might need to keep a variety of sizes on hand for devices like the oro-pharyngeal airway (Guedel airway), which can be used by anyone who’s been trained via well-reviewed resuscitation courses in NZ.

For medical personnel with the necessary training and experience, the laryngeal mask airway (also known as an LMA) may play an increasingly important part in the management of the airway for unconscious patients who are treated outside of the hospital.

Tracheal intubation and the use of other advanced airway techniques should only be performed by individuals who have received comprehensive training and who regularly practise the skills.

*(Films often depict characters who have passed out from drowning or are struggling for air. Their rescuer then enters the scene and begins to breathe into their victim's mouth, causing their chest to rise and fall as it normally would. Technically known as an EAR or the "kiss of life," a person's air supply can be resuscitated with expired air.)

If you want to sign up for airway management training, reach out to us for the latest resuscitation courses in NZ.

Oxygen

The use of oxygen is emphasised in the most recent guidelines for cardiopulmonary resuscitation, and it is imperative that this component remains accessible at all times. To ensure the safety of oxygen cylinders, they must be maintained in accordance with national standards. In the event of certain medical emergencies, such as cardiopulmonary arrest, the non-medical staff at practice should be able to administer high-flow oxygen according to certain guidelines.

Suction

The need for batteries is a drawback for equipment that isn't used as often. In a similar line, the fact that the device needs to be connected to a mains electricity supply not only drives up the cost but also limits the locations in which it can be used. For these reasons, it is advised to use straightforward, mechanical, portable, hand-held suction devices.

Drugs

It has been proven that very few drugs can truly influence the desired outcomes of cardiopulmonary arrest, and therefore, very few drugs are proposed for routine use.

Using 1 mg dose of epinephrine and adrenaline intravenously is usually advised in the most latest edition of the international resuscitation guidelines due to its ability to increase the efficiency of basic life support.

Atropine has been shown to be effective in the treatment of bradycardia, asystole, and pulseless electrical activity (PEA), all of which involve a slow heart rate. In cases of asystole and slow PEA, the dosage is 3 mg, and it is only prescribed once (lower doses are often effective in the treatment of bradycardia). The bare minimum requirement is to have access to both of these medications.

When treating ventricular fibrillation, that’s resistant to defibrillation treatment, the recommended dose of amiodarone is 300 mg administered intravenously.

Prior to admission to the hospital, the use of alkalizing agents, buffers, or calcium salts has not been shown to play an important role. In situations where an individual may have overdosed on opiates, resulting in respiratory depression, the administration of naloxone is suitable.

Intravenous administration of medications is the recommended method, preferably with the use of a catheter inserted into a large vein (such as the antecubital fossa) and then flushed with a bolus of intravenous fluid. In an emergency situation, medications can be injected into a large peripheral vein using a syringe and needle. If the patient has suffered from cardiopulmonary arrest, it is permissible to disregard the possibility of extravasation in this scenario. If a tracheal tube is in place, it’s possible to administer numerous various drugs through the bronchial route. The dose of epinephrine/adrenaline and atropine, that’s usually prescribed through this route, is twice as much as the dose that is administered intravenously.

Minimum Recommended Equipment

• Mask for oxygen with reservoir bag
• One-way valve and a pocket mask
• Defibrillator (AED) equipped with electrodes and a razor
• Needles and syringes
• An oxygen tank (of the suitable size to deliver high flow o2 for a minimum of 30 minutes)
• Epinephrine/Adrenaline
• Atropine Tape Gloves
• Sharps box
• Scissors
• Suction
• Saline flush
• Tissues 

Additional Equipment

• Intravenous cannulae
• Self-inflating bag with reservoir (BVM) for adults and Self-inflating bag with reservoir (BVM) for children
• Oropharyngeal (Guedel) airways
• Amiodarone

There’s no one way of treating patients during an emergency resuscitation crisis. Make sure you’ve received training through professionals with sufficient experience in the field. To sign up for the latest resuscitation courses in NZ, look at our website.