The American Heart Association just recently published its “Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19” online in Circulation on April 9, 2020. Some of the changes are drastic, including prioritizing early intubation to protect staff. If you are a resuscitationist, review these recommendations, we have already implemented nearly all of these in our practice. A brief summary is included below:
- Don airborne/droplet PPE before entering scene/room
- Limit to only absolutely essential personnel in the room
- Use mechanical CPR devices if available
- Attach HEPA filters before ventilation
- Intubate early with HEPA filter placement to minimize aerosolization
- Pause chest compressions during intubations
- Use video laryngoscopy instead of direct laryngoscopy
- Use supraglottic airways if intubation is delayed, or a BVM with HEPA filter
- Minimize circuit disconnects once intubated to reduce aerosolization
- Weigh the risks-benefits when considering continuation of resuscitation
