By ProAssurance Indemnity Company, Inc.

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Acute medical emergencies can occur in any setting. In an emergency, it is important to stabilize the patient and quickly arrange for further intervention. Effective emergency response involves more than just a crash cart; it requires equipment, training, and a plan.

Equipment

It is important to have the capability of basic life support (BLS) to respond to emergencies such as cardiac or respiratory arrest or anaphylactic shock. Equipment may include oxygen, an oxygen mask, a bag resuscitator, oral airways and other essential equipment and drugs. If you treat children, pediatric-sized equipment and medication doses are necessary.

Several factors affect your level of response: patient demographics, location, the types of services rendered in the practice, the availability of medical resources nearby and the level of emergency medical services in the community.

Some physicians’ offices maintain advanced life support (ALS) or advanced cardiovascular life support (ACLS) equipment, which can vary from drug kits to full crash carts with defibrillation and intubation capabilities. This equipment is only as good as the skills of the staff using it. It is important for physicians and staff who use ALS or ACLS equipment to be properly trained to use such emergency equipment. If pediatric ALS or ACLS equipment is in your practice, proper PALS training for physicians and staff is in order, as well.

If you choose to keep BLS, ALS, or ACLS equipment in your practice, check the equipment at least quarterly to monitor accessibility, functionality and each medication’s expiration date. Document these periodic checks on a log sheet.

Training

BLS, ALS, or ACLS training is available from numerous sources, including most hospitals. At minimum, it is prudent for all clinical staff to have BLS training with periodic recertification. Document training and certification in each employee’s personnel file.

Emergency plan

It is important to develop written emergency response procedures that identify basic requirements for handling an office emergency. A well-developed emergency response plan includes the following actions:

• Post a list of emergency telephone numbers near telephones and at the nurses’ station.
• Educate staff concerning their individual responsibilities when an emergency occurs.
• Maintain safety-related equipment, such as flashlights for power failure and visible overhead exit signs for evacuation.
• Ensure staff understands when to call for local emergency assistance. In the case of a medical emergency, designate appropriate staff to begin basic life support (CPR), as well as who will call 911 as soon as possible.
• Conduct routine staff education on individual responsibilities when an emergency occurs; document both education and when emergency drills are conducted.

Physicians insured by ProAssurance may contact our Risk Resource department for prompt answers to liability questions by calling 844-223-9648 or by email.