BRR

Projects
Active?:	active
Program:	CC
Requestor:	unknown
Collection start:
Collection end:

BRR/XBR is an entry we use to identify whether patients are receiving therapeutic hypothermia 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.

Guidelines / Collection Instructions

For any ICU patient with one of the following diagnoses:

• Cardiac Arrest Witnessed 100-2
• Cardiac Arrest Unwitnessed 100-1

code in TMP follows:

• Project: Cooling
• item
  • BRR (BRR stands for "Brrrr" as in shivering or cold)
    • cooling protocol was applied >= 12 hrs (unless patient died before)
    • cooled for >= 12 hrs prior to arrival to your ICU
  • XBR - no cooling protocol applied, or applied for < 12hrs
  • Do not code BRR or XBR when a cooling protocol is used to normalize temperature for any type of non-cardiac arrest patients.

We want to capture all patients who are cooled post cardiac arrest whether they meet criteria for Cardiac Arrest Cooling Protocol or not. A significant portion of patients following cardiac arrest do not meet all the criteria listed, however, based on the available evidence it is reasonable to consider cooling them.

Template:CCMDB Data Integrity Checks

see Check BRR/XBR vs cardiac arrest dx

Background

Start Dates

• collection was started August 2004
• XBR and CCMDB.mdb cross checks were added to detect occasions where entry was just forgotten/missed March 19.09
• reviewed with Kendiss Olafson and Dean Bell.--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

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.

Should this be an ongoing collection?

Data has not been analyzed in some time, so there was discussion on whether we should continue collection. Trish got input from Crititcal care 2017-01, and no one wanted to commit to stopping collection. Discussed at Task meeting and decided to keep collecting and review when we implement ICD10/Canadian Classification of Health Interventions. Template:ICD10