Guidance developed for treating cardiac arrest during COVID-19

(HealthDay)—In a document entitled “Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19,” published online April 9 in Circulation, recommendations are presented for treating victims of cardiac arrest during the coronavirus disease 2019 (COVID-19) pandemic.

Dana P. Edelson, M.D., from the University of Chicago, and colleagues provided interim guidance to help rescuers treat victims of cardiac arrest with suspected or confirmed COVID-19 in an effort to balance the competing interests of providing timely, high-quality care and protecting rescuers.

The authors present general principles for resuscitation in suspected or confirmed COVID-19 patients. These principles include reducing provider exposure to COVID-19 by using personal protective equipment, limiting personnel in the room or on scene, considering replacing manual chest compressions with mechanical cardiopulmonary resuscitation (CPR) machines, and clearly communicating COVID-19 status. Oxygenation and ventilation strategies with lower aerosolization risk should be prioritized, including attaching a high-efficiency particulate air filter to any manual or mechanical ventilation device and minimizing the likelihood of failed intubation by assigning the provider and approach with the best chance of first-pass success to intubate. The appropriateness of starting and continuing resuscitation should be considered. The goals of care should be addressed with COVID-19 patients or their proxy, and policies should be instituted to guide frontline providers for starting and terminating CPR.

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