BRR: Difference between revisions

From CCMDB Wiki
Jump to navigation Jump to search
← Older edit
TOstryzniuk (talk | contribs)
CCMDB_legit, approved, Bureaucrats, Administrators
27,522 edits
mNo edit summary
m Text replacement - "Discuss | who = Tina" to "TT"
 
(142 intermediate revisions by 7 users not shown)
Line 1: Line 1:
BRR is a [[ICU Var 2]] tag that we use in our database for ICU patients who have been placed on the '''Cardiac Arrest Cooling Protocol'''
{{LegacyContent
|explanation=Will be included in ICD10
|successor=[[Targeted Temperature Management (TTM)]]
|content=


*BRR - stands for "Brrrr" as in shivering or cold.
[[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) -->


{{Project
| Project = {{PAGENAME}}
| ProjectActive = active
| ProjectProgram = CC
| ProjectRequestor = Dr. Dean Bell/Dr. Kendiss Olafson
}}


*If ADMIT or COMPLICATION diagnosis is Cardiac Arrest-witnessed (100-2) '''AND''' the cooling protocol is applied '''THEN''' both of the following items must be marked:
{{TT | question =
*[[ICU Var 2]] BRR '''AND''' TISS item [[TISS Neurological | T6-hypothermia]]
* 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. }}


'''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.
We do '''not track cooling for reasons other than cardiac arrest'''.


==Cardiac Arrest Cooling Protocol==
== Guidelines / Collection Instructions ==
*Target temp: 32°C to 34°C for 12 to 24 hours.
For any ICU patient with one of the following diagnoses:
* [[Cardiac arrest]]


*Code is not to be applied when a cooling protocol is used to normalize temperature for non-arrested patients.
or pre-ICD10:
* [[Witnessed Cardiac Arrest]]
* [[Unwitnessed Cardiac Arrest]] 


Taken from the Hypothermia Protocol:
Code in TMP follows:  
*Cooling is indicated if ALL of the following are checked: 
* Project: Cooling  
**Witnessed Arrest (Dx code: 100-2)
*item
**Initial rhythm ventricular fibrillation/tachycardia(Dx code: 131-4, or 131-1)
**'''BRR''' (BRR stands for "Brrrr" as in shivering or cold)
**Time to ACLS <15 minutes
*** cooling protocol was applied at any point post arrest
**Total ACLS time <60 minutes
**'''XBR''' - no cooling protocol applied
**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)
--[[User:TOstryzniuk|TOstryzniuk]] 20:37, 26 January 2009 (CST)


'''Do not code BRR or XBR''' when a cooling protocol is used to normalize temperature for any type of '''non-cardiac arrest''' patients.


Possible Value:
== CCI ==
'''BRR''' if the protocol was applied.
[[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)


[[User:TOstryzniuk|TOstryzniuk]] 16:19, 22 July 2008 (CDT)
== Cross Checks ==
see [[Check BRR/XBR vs cardiac arrest dx]]


===Data Integrity Rules===
== Background ==
*SUGGESTION for updated version of CCMDB: look here:[[CCMDB.mdb_Change_Log_2009#ICU_Var2:_BRR_.26_Complication_DX_code_of_Cardiac_Arrest |Suggestion for Catching missed BRR in ACCESS]].--[[User:TOstryzniuk|TOstryzniuk]] 16:03, 28 January 2009 (CST)
=== '''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


[[Category: ICU Variable Codes]]
=== '''Stop Date''' ===
[[Category: Data Integrity Rules]]
'''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

Legacy Content

This page contains Legacy Content.

Click Expand to show legacy content.

DB task meeting minutes Nov 8.18-- User:TOstryzniuk

Retrieved from "https://ccmdb.kuality.ca/index.php?title=BRR&oldid=143976"