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CONSENSUS
Year : 2021  |  Volume : 14  |  Issue : 6  |  Page : 241-253

Expert consensus on prevention and cardiopulmonary resuscitation for cardiac arrest in COVID-19


1 Department of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China
2 Emergency Department & Intensive Care Unit, Renmin Hospital of Wuhan University, Wuhan 430060, China
3 Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
4 Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, China
5 Department of Emergency, People’s Hospital of Wuhan University, Wuhan 430060, China
6 Department of Emergency Medicine, The First Hospital of Hebei Medical University, Shijiazhuang 050030, China
7 Hospital Infection Control Office, Hainan General Hospital, Haikou 570311, China
8 Department of Occupational Diseases, Jinan Hospital, Jinan 250013, China
9 Department of Emergency Medicine, Hunan Provincial People’s Hospital, Changsha 410005, China
10 Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
11 Department of Emergency Medicine, Zhejiang Provincial People’s Hospital, Hangzhou 310014, China
12 Department of Emergency Department, West China Hospital of Sichuan University, Chengdu 610041, China
13 Department of Infectious Diseases, People’s Hospital of Wuhan University, Wuhan 430060, China
14 Department of Teaching Affairs, The First Hospital of Hebei Medical University, Shijiazhuang 050031, China
15 Department of Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
16 Medical Service Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, China
17 Department of Emergency Medicine, The Central Hospital of Wuhan, Wuhan 430015, China
18 Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
19 Department of Emergency Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
20 Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
21 People’s Hospital of Henan University of Chinese Medicine, Zhengzhou People’s Hospital, Zhengzhou 450003, China
22 Emergency Department of Gansu Provincial People’s Hospital, Lanzhou 730000, China
23 Shaanxi University of Chinese Medicine, Xi’an 712046, China
24 Hanzhong City People’s Hospital, Hanzhong 723000, China
25 Emergency Department in Hospital (T.C.M.) Affiliated to Southwest Medical University, Louzhou 646000, China
26 Department of Emergency Medicine, The 1st Affiliated Hospital of Kunming Medical University, Kunming 650032, China
27 Department of Emergency Medicine, The People’s Hospital of Baoan, Shenzhen 518101, China
28 Department of Emergency Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
29 Department of Emergency Medicine, Guangdong General Hospital of Armed Police, Guangzhou 510507, China
30 Department of Surgery, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201514, China
31 Chinese Journal of Emergency Medicine, Hangzhou 310009, China
32 Department of Emergency Medicine, Beijing Friendship Hospital, Beijing 100050, China
33 Department of Critical Care Medicine, Haikou Municipal People’s Hospital and Central South University Xiangya Medical College Affiliated Hospital, Haikou 570208, China
34 Department of Emergency, The First People’s Hospital of Foshan, Foshan 528000, China

Correspondence Address:
Jie Wei
Emergency Department & Intensive Care Unit, Renmin Hospital of Wuhan University, Wuhan 430060
China
Wei Song
Department of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311
China
Xiangdong Jian
Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1995-7645.315897

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Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.


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