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.

"This guidance draws on evolving science and expert opinion to help health systems and providers mitigate that risk with the hopes of maintaining the survival gains for cardiac arrest achieved over the past two decades," Edelson said in a statement.