Final days to provide feedback on the Emergency Care and Treatment Plan (ECTP)

The Resuscitation Council’s (UK) consultation on the Emergency Care and Treatment Plan (ECTP) closes on Monday. The Resuscitation Council (UK) is giving health professionals the opportunity to provide feedback on the concept of the ECTP and its supporting documents via a survey on their website.

The purpose of an ECTP is to record a summary of decisions about what care and treatment a patient would or would not want to receive, if their health deteriorates and they are unable to make those choices at the time.

The decisions recorded on the form can provide immediate information to guide health professionals who are looking after a patient in an emergency. They may not have met the patient before and may not know full details of the patient’s usual state of health or their wishes. Those professionals may include doctors, nurses and ambulance paramedics. They may be looking after the patient at home, in a hospital, in other places such as a nursing home or hospices, or during a journey by ambulance.

The ECTP aims to ensure that patients receive the best possible treatment for their individual situation. It cannot be used to request or demand treatments that will not be beneficial to them.

This consultation offers paramedics and other pre-hospital professionals an excellent opportunity to voice their views on the ECTP and help shape its future direction. I therefore implore you to take a moment over the next few days to fill in the survey.

LAS improves out of hospital cardiac arrest survival rates

As part of a call to action from health secretary Jeremy Hunt to reduce the number of avoidable deaths in the UK, the Department of Health has published an outcomes strategy on cardiovascular disease (CVD), which will support the NHS and local authorities in delivering improved outcomes for those with or at risk of CVD.

The announcement comes following The Lancet’s recent report on the UK’s health performance, which highlighted that the UK was a long way behind many other countries.

CVD affects the lives of millions of people and is one of the largest causes of death and disability in the UK. However, fast responses to emergencies can save lives and, in some cases, reduce disability.

According to the strategy about 50 000 out of hospital cardiac arrests (OHCA) occur each year in England. Due to a variety of reasons, such as co-morbidity, resuscitation may be inappropriate, and so attempted resuscitation by ambulance services occurs in less than 50% of cases.

However, there is significant variability between ambulance services in rates of successful initial resuscitation (13-27%) and survival to hospital discharge (2-12%) following an OHCA. If survival rates were increased from the overall average (around 7%) to that of the best reported (12%), it is estimated that an additional 1 000 lives could be saved each year.

The strategy revealed that since 2004/2005 the London Ambulance Service (LAS) has improved overall OHCA survival to hospital discharge from a rate of 4% to 11% in 2011/2012. This is as a result of quicker response times; taking heart attack and cardiac arrest patients direct to heart attack centres; and improving bystander resuscitation.

Despite improvement in the LAS, variation in the quality of acute care in other parts of the country mean that much can still be done if patient mortality from CVD is to see considerable change.

The CVD outcomes strategy claims that the NHS Commissioning Board (CB) will work with the Resuscitation Council, the British Heart Foundation and others to promote automatic external defibrillator (AED) site mapping/registration and first responder programmes by ambulance services, and consider ways of increasing the numbers trained in cardiopulmonary resuscitation (CPR) and using automated AEDs.

Taken from Journal of Paramedic Practice, published 14 Mar 2013.