CPR during the Coronavirus Pandemic – Updated 11/06/2020.

The Resuscitation Council UK has suggested some modifications to how we perform CPR during the Coronavirus pandemic.

Every year, up to 60,000 people go into cardiac arrest in the UK. This is when the heart stops suddenly. Without treatment, they will die within minutes. 80% of cardiac arrests happen in the home, so it could be a family member or friend who needs your help.

The best bystander CPR consists of a 999 call for an ambulance, followed by 30 chest compressions and 2 breaths being repeated until an ambulance arrives. A defibrillator should be used if one is available.

Normally, any risk of cross infection is small when carrying out CPR and is weighed up against the inevitability that a person in cardiac arrest will die if CPR isn’t attempted.

However, people may be concerned due to the risk of spreading Coronavirus during the pandemic. As some people with the virus are asymptomatic, we need to assume that everyone is infected and take necessary precautions.

The Resuscitation Council UK has therefore suggested some modifications to how to perform CPR during the Coronavirus pandemic so we can still save lives, whilst keeping people safe.

1. If someone is unresponsive, don’t check for breathing by putting your face close to theirs (as we usually would). Instead, look for the absence of signs of life and the absence of normal breathing. To help, you could consider putting your hand on their diaphragm/tummy to feel for breathing.
2. If they’re not breathing normally, call 999 for an ambulance. If Coronavirus is suspected, tell them when you call 999. If possible, put your phone on loudspeaker.
3. Use a towel of piece of clothing and lay it over the person’s mouth and nose if there is a perceived risk of infection.
4. Start chest compressions at a rate of 100-120 per minute (which is the tempo of ‘Stayin’ Alive’), to a depth of 5-6cms and keep going.
5. Do not do mouth to mouth ventilations.
6. Use a defibrillator if available. Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of infection. 
7. If the rescuer has access to personal protective equipment (PPE) (e.g. FFP3 face mask, disposable gloves, eye protection), these should be worn.
8. After performing compression-only CPR, all rescuers should wash their hands thoroughly with soap and water or alcohol-based hand gel if soap and water is unavailable. They should also seek advice from the NHS 111 Coronavirus advice service or medical adviser.

Cardiac arrest and CPR in children during the Coronavirus pandemic

Cardiac arrest in children is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one. This means rescue breaths/ventilations are crucial to a child’s chances of survival. If a child is not breathing normally and no actions are taken, their heart will stop and full cardiac arrest will occur.

1. Make sure an ambulance is on its way. If Coronavirus is suspected, tell them when you call 999.
2. Giving rescue breaths will increase the risk of transmitting Coronavirus, either to the rescuer or the child/infant.
3. However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.

Further reading on CPR during the Coronavirus pandemic

• First responders should consult the latest advice on the NHS website.
• Laypeople and first responders with a duty of care (workplace First Aiders, sports coaches etc.) should be guided by their employer’s advice.
• Healthcare workers should consult the recommendations from the World Health Organisation and Department of Health and Social Care for further information.
• Public Health Wales has a statement on the Coronavirus pandemic. 
• Updates for Northern Ireland during the Coronavirus pandemic.
• Guidance for health professionals is available from Public Health England.
• Updates are available from Health Protection Scotland.

This guidance may change based on increasing experience in the care of patients with Coronavirus. If you have any questions, please feel free to contact us and we’ll do our best to help. Stay safe.