CardioPulmonary Resuscitation in patients with suspected or confirmed Covid-19. A consensus of the Working group on CardioPulmonary Resuscitation of the Hellenic Society of Cardiology

Abstract

The unprecedented for modern medicine pandemic caused by the SARS-COV-2 virus ("coronavirus", Covid-19) creates in turn new data on the survival of cardiac arrest victims, but mainly on the safety of Cardiopulmonary Resuscitation (CPR) providers. The covid19 pandemic resulted in losses in thousands of lives, and many more people were hospitalized in simple beds or in intensive care units both globally and in Greece. More specifically, in victims of cardiac arrest, both in and out of hospital, the increased mortality and high contagiousness of the SARS-CoV-2 virus put the CPR rescuers in front of new questions of both medical and moral nature. What we all know in Resuscitation, is that we cannot harm the victim and therefore do the most/best we can, it is no longer the full reality. What we need to know and incorporate into decision-making in the resuscitation process is the distribution of limited human and material resources, the potentially very poor outcome of patients with covid-19 and cardiac arrest, and especially that a potential infection of health professionals can lead in the absence of health professionals in the near future. This review tries to incorporate the added skills and precautions for CPR providers in terms of both in hospital and out hospital CPR.

Cardiac arrest: An interdisciplinary scoping review of clinical literature from 2020

“…For resuscitating known COVID‐19 patients, the Hellenic Society of Cardiology recommended full PPE for staff, defibrillation as early as feasible, limitations of the personnel involved, and an emphasis on high‐quality chest compressions over ventilation when responders have already been in close contact with the victim, such as in nursing homes 62 . Authors in the state of Georgia reported disproportionately high mortality rates for COVID‐19‐positive patients experiencing cardiac arrest, leading some authors to suggest that CPR in these patients is futile 63 .…”

The role of automated compression devices in out-of- and in- hospital cardiac arrest. Can we spare rescuers’ hands?

“…17,72 During the SARS-Cov2 virus pandemic (COVID-19), new questions arose regarding CPR and new protocols were implemented in patient management. Modifications were installed by the ERC 73 and also by various national societies 74 in the proposed CPR process (basic and advanced life support algorithm) to protect rescuers from cross-infection. In a setting of OHCA, a piece of cloth is placed on the victim's face before the initiation of CPR while the rescuer is advised to wear a mask and wash his/her hands immediately after.…”

Evaluating CPR training: simulation vs. webinars for Iranian emergency medical technicians during COVID-19

“…The World Health Organization dubbed this incessantly spreading unknown disease COVID-19. This virus was highly contagious, capable of transmitting to others even before the onset of symptoms, posing a high risk of mortality, especially among the elderly and those with underlying health conditions [ 4 – 6 ].…”