Top Things to Know: 2021 Interim Guidance to Healthcare Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19
Published: October 13, 2021
- Global data have indicated that survival outcomes for cardiac arrests have worsened since the start of the COVID-19 pandemic.
- The standard 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care should still be used for patients who are known to be COVID-19 negative.
- COVID-19 vaccines can significantly reduce the risk of healthcare providers becoming infected by the SARS-CoV-2 virus.
- Quality care for cardiac arrests requires rapid initiation of chest compressions. This likely carries a low risk of SARS-CoV-2 transmission to the compressor.
- For witnessed sudden cardiac arrests, chests compressions should be initiated immediately. Providers should don their masks without delaying compressions. For pediatric patients, ventilations should be prioritized. Providers wearing appropriate personal protective equipment (PPE) should replace providers without sufficient PPE. Appropriate PPE for aerosol-generating procedures includes N95 masks with eye protection or positive-airway pressure respirators, gloves, and gowns.
- Defibrillation should be performed as soon as indicated, and should not be delayed to don masks or other PPE.
- HEPA filters should be securely attached along the exhalation ports of any ventilation devices. Low-dead space viral filters or heat and moisture exchanging filters with >99.99% viral filtration efficiency can be installed between the ventilation device and the airway as an alternative.
- Video laryngoscopy and mechanical compression devices may be considered in institutions where they are available and personnel are already trained.
- Advanced care directives and goals of care should be discussed with all patients with suspected or confirmed COVID-19 when they arrive at the hospital and following any significant changes in clinical status. Healthcare providers should commit to ethical and evidence-based organizational policies when making decisions related to initiating and continuing resuscitation.
- Newborn babies are unlikely to spread COVID-19, regardless of their mothers’ COVID-19 status. However, maternal respiratory secretions have the potential to transmit SARS-CoV-2.
Citation
Hsu A, Sasson C, Kudenchuk PJ et al. 2021 Interim Guidance to Healthcare Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circ Cardiovasc Qual Outcomes. 2021;14:e008396.