The Resuscitation Council UK has issued new guidance for the resuscitation of confirmed or suspected Covid-19 patients in healthcare settings. The guidance re-states the need for patients who are at risk of cardiac arrest to be identified so that conversations and decision-making can take place about whether CPR is likely to be appropriate.
The guidance refers to a flowchart which can be found here. It states that, where possible, use of a defibrillator should be attempted first, but full Aerosol Generating PPE must be worn by all members of a resuscitation team before commencing chest compressions or airway procedures – even where this may cause a brief delay in starting chest compressions. The guidance states that “the safety of staff is paramount”. Starting with compression-only CPR and avoiding mouth-to-mouth ventilation/the use of pocket masks is also advised.
However, the Department of Health & Social Care, Public Health Wales, Public Health Agency Northern Ireland, Health Protection Scotland and Public Health England have also issued official guidance on infection prevention and control in healthcare settings (which can be found here). This guidance specifically excludes chest compressions from the list of defined aerosol generating procedures.
The Resuscitation Council UK have explained that their guidance differs due to a variety of factors including expert opinion, previous publications, the approach being taken overseas and protecting the workforce (balanced against the risks of delaying resuscitation). They go on to say it is anticipated NHS Ambulance Services will issue similar advice to ambulance staff.