Resuscitation: Hospital Management of Cardiopulmonary arrest (COVID-19)

Resuscitation: Hospital Management of Cardiopulmonary arrest (COVID-19) was adapted from the newly revised Resuscitation: Hospital Management of Cardiopulmonary arrest CPG. It will be considered for Statewide endorsement on 18 June – NSW are unable to endorse it as it does not match their State guidance.

 

NB Text in italics relates to CPR in the context of COVID-19. This applies to any child in whom COVID-19 is suspected or confirmed . Given the current low prevalence of COVID-19 in Australia (May 2020), particularly in children, resuscitation of children should be as per usual protocols. Individual State policies should be followed.

Key Points

  1. Cardiac arrest should be suspected in an infant or child who is unresponsive and not breathing normally – pulse check should not delay cardiopulmonary resuscitation (CPR)
  2. CPR should be commenced if cardiac arrest is suspected
  3. Ongoing management should be directed by the cardiac rhythm identified
  4. Effective resuscitation relies on a coordinated team and good communication
  5. Children appear to be less likely to transmit COVID-19 to healthcare workers than adults
  6. CPR may cause aerosolisation of virus; airborne precautions(PPE including N95 mask) must be initiated as soon as possible and management must occur in the highest level of isolation available. This should be discussed with a senior clinician and/or ICU
  7. Ideally, CPR should not be delayed for donning of airborne precautions PPE; decisions on providing airway support in the absence of PPE need to be made with the understanding that there may be a small but as yet undefined risk of COVID-19 exposure
  8. If arrest is anticipated, PPE should be donned in advance. If arrest is unanticipated, initial resuscitation, including airway opening, bag valve mask (BVM) ventilation and chest compressions, may be provided by a first responder wearing a mask, gloves and eye protection (at minimum), who should hand over to a staff member in airborne precautions PPE as soon as possible
  9. Staff at increased risk from COVID-19 should consider not working in the resuscitation room

 

 

 

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