Great Britain

Staff told not to resuscitate patients at West Park in Darlington

A MENTAL health trust has told its staff not to resuscitate its patients because it does not have the equipment to safely carry out the procedure.

The Tees, Esk and Wear Valleys NHS Foundation Trust issued new guidance to staff last week which advised them against CPR during a medical emergency.

An internal email sent by the trust’s medical director to staff revealed the trust did not have enhanced Personal Protective Equipment in place for resuscitation.

It said PPE including, gloves, long sleeved gowns, eye protection and FFP3 face masks were currently “not available” within the trust.

As such, staff were advised not to commence the CPR procedure even if advised to by ambulance control or life-saving equipment.

Staff were also told "not to administer rescue breaths, use a manual resuscitator or create an airway or intubate the patient under any circumstances, due to the ongoing coronavirus pandemic".

But a nurse at West Park Mental Health Hospital in Darlington said patients were at risk of “irreversible damage” or even death under the new guidance.

She told The Northern Echo: “We cannot resuscitate patients as we do not have the correct PPE.

“If somebody is to self-harm or has a medical emergency, without PPE, it is going to be nigh on impossible to respond to.

“It goes against everything I believe in, we have patients who might arrest for a number of reasons – we are trained in basic life support and are not going to be able to do it.”

The nurse, who wishes to remain anonymous, said colleagues had been placed in an “impossible” position when choosing between saving lives and being dismissed.

She said: “It all feels very wrong that people don’t realise how important PPE is. I can’t watch a patient die in front of me, I can’t just stand there and do nothing.”

Under guidance from the trust, staff are told to preserve life by only using limited contact, including checking for a pulse or through the use of a defibrillator.

However, the nurse said: “If we keep someone’s heart going through defibrillator without rescue breaths, their brain may be starved of oxygen and by the time the ambulance arrives, the damage will be done.

“The defibrillator tells us when to apply rescue breaths and is constantly monitoring the patient’s heart rate and we’re going to have to ignore that.

“I could never have imagined that anything like this – it’s heartbreaking.”

However, responding to the claims over patient safety, the trust said cardiac and respiratory arrests were a rare event in mental health hospitals and that the trust was following national guidance on covid-19.

Dr Ahmad Khouja, Medical Director at Tees, Esk and Wear Valleys NHS Foundation Trust, said: “We are doing everything we can to protect the patients in our care and our staff.

“Fortunately cardiac and respiratory arrests are a rare event in mental health hospitals.

“However, our staff are trained in how to respond effectively whilst being mindful of their own health and safety and that of others.”

“We follow national guidance, and in light of the current coronavirus pandemic this has included clarity on what PPE should be worn by those who are first responders and whilst waiting for an ambulance team to arrive, which has always been our standard procedure.

“The guidance to NHS staff carrying out CPR has also changed regarding the type of PPE required.

“This is due to the very high possibility that during chest compressions and maintaining an airway that staff will be exposed to the virus.

“Like many trusts, we are waiting for the delivery of the required PPE kit which needs to be individually fitted for staff.

“The national priority is quite rightly to ensure that our acute hospitals and ambulance services have the correct PPE, given the very high frequency in which they have to manage a cardiac arrest.

“We continue to support all efforts to increase the production and delivery of PPE for health and care staff.”

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