COVID-19 Guidance
COVID-19 Guidance
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When carrying out cardiopulmonary resuscitation (CPR) on patients during the COVID-19 pandemic, there are some specific differences to be aware of.
Firstly, safety is paramount.
The key safety priorities are:
Self
Colleagues and bystanders
The patient
The time required to achieve safe care is an acceptable part of the resuscitation process.
Identify, as early as possible, any patients with a COVID-19 like illness, who are at risk of acute deterioration or cardiac arrest, then take appropriate steps to prevent cardiac arrest and avoid unprotected CPR.
Patients
The use of physiological track-and-trigger systems, for example NEWS2, will enable early detection of acutely ill patients.
In situations where resuscitation is deemed inappropriate, decisions must be made and communicated.
NICE has posted criteria for admission to critical care during the COVID-19 pandemic. View website
Patients who may not benefit from admission to critical care unit, for example those with a clinical frailty score of 5 or more, are extremely unlikely to survive attempted resuscitation after cardiac arrest. For such patients, a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is likely to be appropriate.
Personal Protective Equipment (PPE)
Public Health England’s guidance of 24 April allows Trusts to opt for a level of PPE they consider appropriate to best ensure healthcare staff safety during resuscitation. Equipment must be made readily available to protect staff during resuscitation attempts. It is acknowledged that this may cause a brief delay to starting chest compressions. Applying defibrillator patches and delivering a shock from an AED/defibrillator is not an aerosol generating procedure and can be undertaken with the healthcare provider wearing a surgical face mask, apron and gloves prior to commencing CPR.
It is important that you are familiar with local policies and procedures for the management of cardiac arrest, including the local guidance for use of PPE, for patients with suspected or confirmed COVID-19 infections. For further information see RCUK Statement on PHE PPE Guidance.
Resuscitation of COVID-19 Patients in Hospital
The following infographic on the resuscitation of COVID-19 patients in a healthcare setting has been produced by the Resuscitation Council UK. They have also created a flowchart which you can view by selecting this link.
For the most up-to-date guidance, and to download these resources, please visit the Resuscitation Council UK website at this link.
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