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Covid-19: Doctors are told not to perform CPR on patients in cardiac arrest


Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE).

The guidance from the University Hospitals Birmingham NHS Foundation Trust says that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a “shockable” rhythm. But if this fails to restart the heart “further resuscitation is futile,” it says.

If a patient with suspected covid-19 is in cardiac arrest they should be given cardiac compressions and be ventilated only if they are in the emergency department and the person attending them is wearing aerosol generating procedures (AGP) PPE. That means wearing an FFP3 mask, full gown with long sleeves, gloves, and eye protection.

The advice rests on the premise that performing cardiac compressions risks virus particles being released into the air that could infect staff.

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Source: BMJ, 29 March 2020

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Hi There,

I think this is true for all hospitals.  Chest compressions are classed as an aerosoled treatment, so poses a high risk of transmission to the attender.  Please see the updated guidance by the resuscitation council UK .

It is not that doctors are being told not to perform CPR, they are being told to wear the correct PPE before they commence CPR.  This may cause a delay in CPR, this also highlights the importance of discussing treatment escalation plans with patients and their families.

Please also see @Ken Spearpoint blog - 

 

Adult_ALS-COVID-19 (1).pdf

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