BRR

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Purpose

To identify ALL patients who are treated with therapeutic hypothermia following a Cardiac Arrest Witnessed 100-2 or Cardiac Arrest Unwitnessed 100-1. By identifying all patients that receive this therapy a further audit can be done to identify if therapy was appropriate or not.

  • reviewed with Kendiss Olafson and Dean Bell.--TOstryzniuk 17:58, 26 August 2009 (CDT)

Code used

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

  • BRR - stands for "Brrrr" as in shivering or cold.

Possible values

  • BRR - mean cooling protocol applied for cardiac arrest (started August 2004).
  • XBR - means no cooling protocol applied for cardiac arrest (Added March 19.09)

Cardiac Arrest Cooling Protocol

  • Target temp: 32°C to 34°C for 12 to 24 hours.
  • Code is not to be applied when a cooling protocol is used to normalize temperature for non-arrested patients.

Taken from the Hypothermia Protocol:

  • Cooling is indicated if all of the following are checked:
    • Cardiac Arrest Witnessed 100-2
    • Initial rhythm ventricular fibrillation/tachycardia(Dx code: 131-4, or 131-1)
    • Time to ACLS <15 minutes
    • Total ACLS time <60 minutes
    • Persistent Glasgow Coma Scale < or = 9
    • Systolic BP currently over 90 mmHg (pressors allowed)
    • < 8 hours elapsed since Return of Spontaneous Circulation (ROSC)

Data Integrity Rules

If Cardiac Arrest Witnessed 100-2 or Cardiac Arrest Unwitnessed 100-1 in admit or complications diagnosis field then both the following must also be marked:

Purpose of marking BRR or BRX

By marking BRR or BRX for all patients with the diagnosis of witnessed cardiac arrest (100-2) or unwitnessed cardiac arrest (100-1), collectors will have verified at the time of collection that they did not miss marking that a patient was placed on the cooling protocol. This will eliminate the query that gets send back to collectors to double check this item.