New Guidelines for Performing CPR to COVID-19 Patients

It is vital to ensure the safety of the rescuer while providing the utmost care to the victim. The American heart association, alongside other bodies, have provided a new set of guidelines when performing CPR to Covid-19 victims:

• With the prevalence of Covid-19, health workers are reluctant to provide CPR to cardiac arrest victims. However, it is essential to note that not every cardiac arrest victim is infected with Covid-19.
• For essential life support, prioritize hands-only CPR — Hands-only CPR is safer. However, health workers should wear full PPE (personal protective equipment).
• When performing CPR, first cover the victim’s mouth and nose with a piece of cloth or towel. In hospitalized care, Covid-19 patients who experience cardiac arrest should be resuscitated and defibrillated.
• Use the AED as soon as it is available to improve the outcome. Studies show that the AED doesn’t increase aerosol generation.
• Don’t leave anything at risk with the use of personal protective equipment. PPE is critical for health workers or rescuers taking care of Covid-19 patients. Before accessing the scene, all rescuers should wear the recommended PPE as per the institutional guidelines. These include: gowns, gloves, eye protection, and respirators.
• Mechanical CPR devices should be used instead of manual machines as this will reduce the number of professionals required to attend to a specific patient.
• The healthcare workers performing resuscitation procedures should be minimized as well as those entering isolation rooms. It helps in the reduction of the rate of exposure to the virus.
• The AHA recommends that doors remain closed during resuscitation to minimize the spread of the virus to the surrounding space.
• New healthcare workers arriving at the scene should be made aware of the Covid-19 status of the victim. Communication should be made to all health workers working in the facility. When calling for emergency response teams, the responder should also notify them if the patient has been found to have the infection.
• To reduce aerosolizing effects, intubated patients should remain in mechanical ventilators with high-efficiency particulate air filters (HEPA). It helps reduce the impact of aerosolization and maintains a closed circuit.
• The ventilation should be adjusted to pressure control mode. The fraction of inspired oxygen (FiO2) should also be adjusted to 0.1. The pressure should also be adjusted to allow for the necessary chest rise, adults to 6Ml/kg and 4–6Ml/kg for neonatal.
• Intubation procedures are highly aerosol-generating. The health care provider recommended that the health care provider use a cuffed endotracheal tube connected to a ventilator with a HEPA filter in the exhaled gas path and an inline suction catheter. The resulting circuit is safer and less likely to generate aerosol.

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