COVID-19: resuscitation in community settings
A statement from the UK Resus Council
Whenever CPR is carried out, particularly on an unknown victim, there is some risk of cross infection, associated particularly with giving rescue breaths. Normally the risk is very small and is set against the inevitability that a person in cardiac arrest will die if no assistance is given. The first things to do are:
- Shout for help
- Dial 999 – stating ‘Cardiac Arrest COVID-19
- Recognise cardiac arrest by looking for the absence of signs of life and the absence of normal breathing.
- Do not listen or feel for breathing by placing your ear and cheek close to the patient’s mouth
- If you are in doubt about confirming cardiac arrest, the default position is to start chest compressions until help arrives
- If there is a perceived risk of infection, rescuers should place a cloth/towel over the patient’s mouth and nose and attempt compression only CPR and early defibrillation. Put hands together in the middle of the chest and push hard and fast
- Early use of a defibrillator significantly increases the person’s chance of survival and does not increase risk of infection
- If the rescuer has access to PPE, these should be worn
- After performing compression only CPR, all rescuers should wash their hands thoroughly with soap and water, alcohol-based hand gel is a convenient alternative.
- The rescuer should seek advice from the NHS 111 coronavirus service or medical adviser
Resuscitating a child
A paediatric cardiac arrest is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one, making ventilations crucial to the child’s chances of survival. The importance of calling an ambulance and taking immediate action cannot be stressed highly enough.
If a child is not breathing normally and no actions are taken, their heart will stop, and full cardiac arrest will occur. Therefore, if there is any doubt what to do, this statement should be used.
It is likely that the child/infant having an out of hospital cardiac arrest will be known to you. We accept that doing rescue breathes will increase the risk of transmitting COVID-19 virus, either to the rescuer or the child/infant.
However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.