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Mental health trust tells staff not to do CPR over protective gear shortage

Staff ata major mental health trust have been told not to resuscitate patientsduring the coronavirus pandemic because of a lack of protective equipment tosafely carry out the procedure.  

The Tees, Esk and Wear Valleys NHSFoundation Trust, in County Durham, issued new guidance to staff last weekwhich advised them against CPR during a medical emergency.

An internal email sent by the medical director revealed the trust did not have enhanced Personal Protective Equipment (PPE) in place for resuscitation. It said gloves, long sleeved gowns, eye protection and FFP3 face masks were currently ‘not available’ within the trust and as such, staff should not commence life-saving procedures even if advised to by ambulance control.

The email told staff  ‘not to administer rescue breaths, use a manual resuscitator or create an airway or incubate the patient under any circumstances, due to the ongoing coronavirus pandemic’. But a nurse at West Park Mental Health Hospital in Darlington, which is managed by the trust, said patients were at risk of ‘irreversible damage’ or even death under the new guidance.

She said: ‘We cannot resuscitate patients aswe 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.

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‘It goes against everything I believein, we have patients who might arrest for a number of reasons – we are trainedin 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 that forced them to choose between saving lives and being dismissed.

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

However, the nurse said: ‘If we keepsomeone’s heart going through defibrillator without rescue breaths, their brainmay be starved of oxygen and by the time the ambulance arrives, the damage willbe done.

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

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

Responding to the claims over patientsafety, the trust said Cardiac and respiratory arrests were a rare event inmental health hospitals and that the trust was following national guidance oncovid-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.’

This comes as nurses across the UK say they are working without any masks, gowns and gloves due to a shortage of PPE equipment.

The Royal College of Nursing (RCN) said it is ‘unacceptable’ that weeks into the crisis some nurses are yet to be provided with the necessary protective gear.

It has called for minimum basic levels of PPE to be rolled out for staff in all settings – hospitals, care homes, or in the community – but it said that this is’ ‘yet to to be provided.’

Dame Donna Kinnair, chief executive and general secretary of the RCN, said on Monday: ‘I am hearing from nurses who are treating patients in Covid-19 wards without any protection at all. This cannot continue. They are putting themselves, their families, and their patients at risk.

‘We need action, we need equipment, we need it now.’

One in five nurses and one in four doctors are off sick or self-isolating as hospitals battle with a surge in coronavirus cases. Global shortages of the equipment medics and carers need to protect themselves against Covid-19 have led to shortfalls in the UK and yesterday it was reported medics were resorting to hiding the equipment they need to keep themselves safe.

The Department of Health and Social Care said it has issued millions of pieces of equipment and set up a national helpline so those in need can ask for more.

Communities Secretary Robert Jenrick told a Downing Street briefing on Sunday that 170 million masks, some 42.8 million gloves, 13.7 million aprons, 182,000 gowns, almost 10 million items of cleaning equipment and 2.3 million pairs of eye protectors were being delivered to frontline staff.

But in further developments today, the Health Care Supply Association (HCSA), which represents procurement and supply professionals within the healthcare sector in the UK, warned of ‘serious supply issues’ in hospitals, especially of protective gowns.

In a since deleted tweet, HSCA chief officer Alan Hoskins wrote ‘What a day no gowns @NHSSupplyChain rang every number escalated to NHSE just got message back no stock can’t help can send you a ppe pack losing the will to live god help us all.’

An NHS spokesperson said gowns were being delivered to hospitals on Monday night and Tuesday,

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