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'''Cardiac Arrest Cooling Protocol''' for ICU patients.
{{LegacyContent
*If cooling protocol is started on a patient who has arrested, the code BRR must be marked in [[ICU Var 2]].
|explanation=Will be included in ICD10
|successor=[[Targeted Temperature Management (TTM)]]
|content=


[[Task Team Meeting - Rolling Agenda and Minutes#ICU Database Task Group Meeting – November 8, 2018 | DB task meeting minutes Nov 8.18]]-- User:TOstryzniuk|Trish Ostryzniuk]] 13:41, 2018 December 24 (CST) -->


*Target temp: 32°C to 34°C for 12 to 24 hours.__[[User:TOstryzniuk|TOstryzniuk]] 00:30, 24 January 2009 (CST)
{{Project
| Project = {{PAGENAME}}
| ProjectActive = active
| ProjectProgram = CC
| ProjectRequestor = Dr. Dean Bell/Dr. Kendiss Olafson
}}


{{TT | question =
* start and stop date should be in table? [[User:TOstryzniuk|Trish Ostryzniuk]] 13:56, 2018 December 24 (CST)
** yes, it's somewhere on my list to change all the tmp project templates to have the dates built in. Tagged now so staying on the list. }}


Taken from the Hypothermia Protocol:
'''BRR/XBR''' is an entry we use to identify whether patients are receiving therapeutic hypothermia [[Targeted Temperature Management (TTM)]] following a '''cardiac arrest''' according to the [[Cardiac Arrest Cooling Protocol]]. By identifying all patients that receive this therapy a further audit can be done to identify if therapy was appropriate or not.
*Cooling is indicated if ALL of the following are checked: 
We do '''not track cooling for reasons other than cardiac arrest'''.
**Witnessed Arrest
**Initial rhythm ventricular fibrillation/tachycardia
**Time to ACLS <15 minutes
**Total ACLS time <60 minutes
**Persistent GCS < or = 9
**Systolic BP currently over 90 mmHg (pressors allowed)
**< 8 hours elapsed since Return of Spontaneous Circulation (ROSC)
--[[User:LKolesar|LKolesar]] 13:54, 22 January 2009 (CST)


== Guidelines / Collection Instructions ==
For any ICU patient with one of the following diagnoses:
* [[Cardiac arrest]]


or pre-ICD10:
* [[Witnessed Cardiac Arrest]]
* [[Unwitnessed Cardiac Arrest]] 


Code in TMP follows:
* Project: Cooling
*item
**'''BRR''' (BRR stands for "Brrrr" as in shivering or cold)
*** cooling protocol was applied at any point post arrest
**'''XBR''' - no cooling protocol applied


[[Category: Data Collection Guide]]
'''Do not code BRR or XBR''' when a cooling protocol is used to normalize temperature for any type of '''non-cardiac arrest''' patients.
[[Category: Critical Care Element]]
 
== CCI ==
[[Task Team Meeting - Rolling Agenda and Minutes#ICU Database Task Group Meeting – October 3, 2018]] confirmed that we can stop collecting this when we start collecting CCI [[Targeted Temperature Management (TTM)]]. We may want to import the old entries as CCI codes? Ttenbergen 00:19, 2018 October 10 (CDT)
 
== Cross Checks ==
see [[Check BRR/XBR vs cardiac arrest dx]]
 
== Background ==
=== '''Start Dates''' ===
* '''2004 August'''
* XBR and [[CCMDB.accdb]] cross checks were added to detect occasions where entry was just forgotten/missed '''March 19.09'''
* reviewed with Kendiss Olafson and Dean Bell.--[[User:TOstryzniuk|TOstryzniuk]] 17:58, 26 August 2009 (CDT)
* cross-checks changed to include [[Unwitnessed Cardiac Arrest]] '''August 27.09'''
* moved from ICU Var 2 into TMP on Dec 18, 2014
 
=== '''Stop Date''' ===
'''2018 Dec 31'''
*Stop in TMP.  All patient still in unit after this date, code as: [[Targeted Temperature Management (TTM)]]
 
=== Why the code XBR? ===
The rationale for the code XBR is to identify those patients who had a cardiac arrest but '''were not cooled''' regardless if they met criteria for cooling or not. XBR was implemented after an audit of cardiac arrest was done and it was found that there were several cardiac arrests coded that were missing code BRR.  By leaving Variable 2 blank for a cardiac arrest, it is not clear to Kendiss or Julie whether a data collector missed tagging it or if indeed cooling was not applied.  Coding XBR indicates to both Kendiss and Julie that a collector verfied that the cooling protocol was not applied. 
 
=== removed 12 hr requirement ===
Discussed at task 2018-04-11: we are removing the 12 hr requirement because the use and application of the protocol has changed since inception and this restriction is no longer reasonable.
 
== Related articles ==
{{Related Articles}}
 
[[Category:Project ICU only]]
[[Category:Arrest]]
}}

Latest revision as of 16:07, 2020 May 5

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DB task meeting minutes Nov 8.18-- User:TOstryzniuk

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