1. Purpose & Scope

This protocol provides the step-by-step emergency response for sudden cardiac arrest and collapse events at Newcastle Cosmetic Doctor. It aligns with the latest Australian Resuscitation Council (ARC) / ANZCOR recommendations and Ahpra expectations for emergency readiness in cosmetic practice. All clinical staff must complete annual BLS/CPR training and participate in drills.

2. Governance & Standards

This protocol is based on ARC Guideline 8 and related ANZCOR BLS statements. It also incorporates Ahpra’s 2025 cosmetic procedure guidelines regarding emergency preparedness, documentation, and training. Local NSW outpatient emergency response guidance informs operational details.

3. Recognition of Cardiac Arrest

• Unresponsive (no movement/response to voice or gentle shake).
• Not breathing normally (absent or agonal gasps).
• If in doubt, commence CPR without delay; pulse check should not delay compressions for lay-rescuer BLS; trained providers may perform a rapid pulse check (≤10 s).

4. Step-by-Step BLS/CPR – Adults

1. Danger: ensure scene safety for staff and patient.
2. Response: check for responsiveness (voice/shake).
3. Send for help: call 000 and summon AED/oxygen kit.
4. Airway: open with head tilt–chin lift; clear visible obstruction.
5. Breathing: check for normal breathing ≤10 s; if not normal → start CPR.
6. CPR: 30 compressions : 2 breaths. Depth ≥5 cm (~one-third chest depth); rate 100–120/min; allow full recoil; minimise pauses.
7. AED: attach as soon as available; follow prompts; resume CPR immediately after each shock.
8. Continue cycles until signs of life or paramedic takeover; rotate compressors every 2 minutes to reduce fatigue.

5. Paediatric Adaptations

• Single rescuer: ratio 30:2; Two rescuers: 15:2.
• Compression depth ~one-third of chest depth; rate 100–120/min.
• Rescue breaths are especially important in paediatrics; ensure good seal and visible chest rise.

6. Airway & Breathing Support

• Use pocket mask or bag-valve-mask where trained to reduce infection risk; apply high-flow oxygen when available.
• Suction equipment should be accessible for secretions or obstruction; airway adjuncts (OPA/NPA) if trained and indicated.

7. Automated External Defibrillator (AED)

• Maintain AED onsite; monthly checks and pad expiry logs.
• Apply pads immediately once available; follow prompts; minimise CPR interruptions; resume compressions after shock.

8. Post-Resuscitation Care

• Handover includes times, interventions, drugs, shocks, rhythms; continue oxygen and monitoring until transfer.
• Document event comprehensively; debrief staff within 24 hours; restock and recheck AED/kit; log for quality improvement audit.

9. Training, Drills & Readiness

• Annual BLS/CPR certification for all clinical staff; AED familiarisation; orientation for new staff before clinical duties.
• Monthly AED and emergency kit checklist (pads, battery, oxygen, airways).
• Quarterly mock-code drills with timed metrics (time-to-CPR, time-to-AED); action items tracked to closure.

10. SHORT VERSION – Emergency Steps (Post on Wall)

• D – Danger: make safe.
• R – Response: no response → shout for help/000.
• S – Send: bring AED + emergency kit.
• A – Airway: head tilt–chin lift; clear obstruction.
• B – Breathing: not normal? start CPR.
• C – Compressions: 30:2, depth ≥5 cm, rate 100–120/min.
• Defibrillate: attach AED ASAP; follow prompts; resume CPR after shock.
• Rotate compressors every 2 min; minimise pauses.
• Continue until signs of life or paramedics take over; document.

Sources

1. Australian Resuscitation Council (ARC) 2025, Guideline 8 – Cardiopulmonary Resuscitation, viewed 3 Oct 2025, https://resus.org.au/guidelines/
2. Australian and New Zealand Committee on Resuscitation (ANZCOR) 2025, BLS/ALS consolidated guidelines, viewed 3 Oct 2025, https://resus.org.au/anzcor-guidelines/
3. Australian Health Practitioner Regulation Agency (Ahpra) 2025, Guidelines for non-surgical cosmetic procedures, viewed 3 Oct 2025, https://www.ahpra.gov.au/News/2025-01-31-Guidelines.aspx
4. NSW Health 2024, Cardiac arrest response protocols in outpatient settings, viewed 3 Oct 2025, https://www.health.nsw.gov.au/clinical/cardiac/pages/outpatient-response.aspx