This article relates to the CQC key question: Is your practice safe?
All GP practices must be equipped to deal with a medical emergency and all staff should be suitably trained.
Ideally there should be a named resuscitation lead in GP practices to ensure:
- the practice has access to resuscitation advice, training and practice
- quality standards are maintained
- basic checks of equipment.
Agreed principles for defibrillators, oxygen and oximeters describes requirements for these items of equipment. This article looks at the equipment required for CPR in GP practices, including for paediatric use, and required staff training.
The guidance relates to Regulation 12 (‘Providers must make sure that the premises and any equipment used is safe and where applicable, available in sufficient quantities.’) and Regulation 18 (‘Staff must receive the support, training, professional development, supervision and appraisals that are necessary for them to carry out their role and responsibilities’).
The Resuscitation Council (UK) has compiled a list of minimum suggested equipment to support CPR in primary care settings.
We recognise individual practice requirements will vary. The list is not comprehensive and should be interpreted on a place by place basis. These items should be available for immediate use.
Minimum suggested equipment to support CPR in GP practices
- Protective equipment - gloves, aprons, eye protection
- Pocket mask (adult) with oxygen port. This may be used inverted in infants
- Oxygen cylinder (with key where necessary).
- Oxygen tubing
- Automated external defibrillator (AED):
- Preferably with facilities for paediatric use as well as use in adults.
- Type of AED and location determined by a local risk assessment.
- AEDs are not intended for use in infants (less than 12 months old) and this should be considered at risk assessment.
- Adhesive defibrillator pads – spare set also recommended
- Absorbent towel - to dry chest if necessary
CPR on children - paediatric defibrillation pads
AEDs generally have two sizes of paddles: adult and infant.
The American Heart Association (AHA) currently recommends using the largest paddles or self-adhering electrodes that will fit on the child's chest without touching (when possible, leave about 3 cm between the paddles or electrodes).
The European Resuscitation Council Guidelines state that:
- Standard AEDs are suitable to use for children over eight years old.
- For children between one and eight years use:
- paediatric pads with an attenuator or a paediatric mode if available;
- if not, use the unmodified machine, taking care to ensure that the adult pads do not overlap.
It is not recommended to use AEDs for children less than one year old.
Therefore, it is not a requirement for most practices to carry paediatric defibrillator pads - this should be subject to local needs.
All staff, including non-clinical, should undergo regular training in adult and child resuscitation appropriate to their position. For example, clinical staff should be able to recognise cardiorespiratory arrest, call for help and start CPR with defibrillation as appropriate, and receive annual training updates.
It is essential to retain documentary evidence of completed and approved CPR training.
All staff should understand their role as part of the team response to resuscitation.
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC. This article is one of Professor Sparrow's mythbusters on the CQC website.
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection