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

Wei Song; Yanhong Ouyang; Yuanshui Liu; Heping XU; Feng Zhan; Wenteng Chen; Jun Zhang; Shengyang YI; Jie Wei; Xiangdong Jian; Deren Wang; Xianjin DU; Ying Chen; Yingqi Zhang; Shuming Xianyu; Qiong Ning; Xiang LI; Xiaotong Han; Yan Cao; Tao YU; Wenwei Cai; Sheng'ang Zhou; Yu Cao; Xiaobei Chen; Shunjiang XU; Zong'an Liang; Duohu WU; Fen AI; Zhong Wang; Qingyi Meng; Yuhong MI; Sisen Zhang; Rongjia Yang; Shouchun Yan; Wenbin Han; Yong Lin; Chuanyun Qian; Wenwu Zhang; Yan Xiong; Jun LV; Baochi Liu; Xiaojun HE; Xuelian Sun; Yufang Cao; Tian'en Zhou

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

Author: Wei SONG ¹ ; Yanhong OUYANG ¹ ; Yuanshui LIU ¹ ; Heping XU ¹ ; Feng ZHAN ¹ ; Wenteng CHEN ¹ ; Jun ZHANG ¹ ; Shengyang YI ¹ ; Jie WEI ² ; Xiangdong JIAN ³ ; Deren WANG ⁴ ; Xianjin DU ⁵ ; Ying CHEN ⁶ ; Yingqi ZHANG ⁶ ; Shuming XIANYU ⁷ ; Qiong NING ⁸ ; Xiang LI ⁹ ; Xiaotong HAN ⁹ ; Yan CAO ⁹ ; Tao YU ¹⁰ ; Wenwei CAI ¹¹ ; Sheng'Ang ZHOU ¹¹ ; Yu CAO ¹² ; Xiaobei CHEN ¹³ ; Shunjiang XU ¹⁴ ; Zong'An LIANG ¹⁵ ; Duohu WU ¹⁶ ; Fen AI ¹⁷ ; Zhong WANG ¹⁸ ; Qingyi MENG ¹⁹ ; Yuhong MI ²⁰ ; Sisen ZHANG ²¹ ; Rongjia YANG ²² ; Shouchun YAN ²³ ; Wenbin HAN ²⁴ ; Yong LIN ²⁵ ; Chuanyun QIAN ²⁶ ; Wenwu ZHANG ²⁷ ; Yan XIONG ²⁸ ; Jun LV ²⁹ ; Baochi LIU ³⁰ ; Xiaojun HE ³¹ ; Xuelian SUN ³² ; Yufang CAO ³³ ; Tian'En ZHOU ³⁴
Author Information

1. Department of Emergency Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University
2. Emergency Department and Intensive Care Unit, Renmin Hospital of Wuhan University
3. Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University
4. Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital of Sichuan University
5. Department of Emergency, People's Hospital of Wuhan University
6. Department of Emergency Medicine, The First Hospital of Hebei Medical University
7. Hospital Infection Control Office, Hainan General Hospital
8. Department of Occupational Diseases, Jinan Hospital
9. Department of Emergency Medicine, Hunan Provincial People's Hospital
10. Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
11. Department of Emergency Medicine, Zhejiang Provincial People's Hospital
12. Department of Emergency Department, West China Hospital of Sichuan University
13. Department of Infectious Diseases, People's Hospital of Wuhan University
14. Department of Teaching Affairs, The First Hospital of Hebei Medical University
15. Department of Pulmonary and Critical Care Medicine, West China Hospital of Sichuan University
16. Medical Service Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University
17. Department of Emergency Medicine, The Central Hospital of Wuhan
18. Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University
19. Department of Emergency Medicine, The First Medical Center, Chinese PLA General Hospital
20. Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University
21. People's Hospital of Henan University of Chinese Medicine, Zhengzhou People's Hospital
22. Emergency Department of Gansu Provincial People's Hospital
23. Shaanxi University of Chinese Medicine
24. Hanzhong City People's Hospital
25. Emergency Department in Hospital (T.C.M.) Affiliated to Southwest Medical University
26. Department of Emergency Medicine, The 1st Affiliated Hospital of Kunming Medical University
27. Department of Emergency Medicine, The People's Hospital of Baoan
28. Department of Emergency Medicine, The First Affiliated Hospital of Sun Yat-sen University
29. Department of Emergency Medicine, Guangdong General Hospital of Armed Police
30. Department of Surgery, Shanghai Public Health Clinical Center Affiliated to Fudan University
31. Chinese Journal of Emergency Medicine
32. Department of Emergency Medicine, Beijing Friendship Hospital
33. Department of Critical Care Medicine, Haikou Municipal People's Hospital and Central South University Xiangya Medical, College Affiliated Hospital
34. Department of Emergency, The First People's Hospital of Foshan
Publication Type:Journal Article
From: Asian Pacific Journal of Tropical Medicine 2021;14(6):241-253
CountryChina
Language:Chinese
Abstract: 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.