Administering CPR and the Coronavirus Risk

Source: Pavel Rusak/123RF

Members of the public who have been trained in cardiopulmonary resuscitation (CPR) usually spring into action when called upon to aid someone who appears to be suffering from a heart attack or stroke (if the victim has lost consciousness, in the latter case).

Given how stretched emergency response resources are during the COVID-19 pandemic, and longer-than-usual response times, more often, situations arise when immediate action is needed.

According to the American Heart Association (AHA), providing potentially lifesaving CPR requires extra considerations amid the coronavirus crisis.

Initiating CPR right away, rather than waiting for medical personnel to arrive, makes a big difference. CPR initiated by a bystander can nearly double the chance of survival from cardiac arrest, from about 7% to 14%.

But, given how the virus is so easily transmitted, can applying CPR, using chest compressions and mouth-to-mouth resuscitation, present a risk to both patient and the bystander giving the CPR?

In COVID-19 patients, performing chest compressions has the potential to spread the virus.

For cardiac arrests in public places, such as a grocery store, pharmacy, or other situations, the current guidance says bystanders should at least perform Hands-Only CPR. There is the option to use a face mask or cloth to cover the mouth and nose of the rescuer and/or the victim to reduce the risk of virus transmission, although no data is available to support such a practice.

The AHA states that bystanders in public places must balance their own risk factors for complications if they get COVID-19 against the knowledge that survival rates without CPR are dismal.

But calling 911 is key, as is deciding quickly about whether to perform CPR.

Dr. Dana Edelson, executive medical director for rescue care at the University of Chicago School of Medicine, says, “About 70% of cardiac arrests that occur outside a hospital happen in a home or residential setting, and with stay-at-home orders in effect for most of the country, “it’s hard to imagine that percentage not increasing. The most likely people to be rescuers are other household members.”

Edelson adds: “Traditional CPR, which incorporates rescue breaths in addition to chest compressions, is still recommended for children because they more often experience cardiac arrest as a result of a respiratory event rather than a cardiac event.”

Would you be able to administer CPR to a family member or a member of the public? Now, more than ever, being trained in CPR is of the utmost importance.

Mark Komins, EMS Director at Safety Unlimited, Inc., says: “It is worse to wait and not perform CPR than the risk of contracting COVID 19.  In our classes, we have taken every recommended step from the Ventura County Public Health, CDC, and the American Heart Association.

Komins added: “We have reduced our class size, we are doing temperature checks and COVID questionnaires as students arrive, require them to wash their hands, provide one-time use mouth-pieces, and reduce the sharing of manikins.”

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