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Some health staff in UK warned over treating cardiac arrest


(Stock photo)

(Stock photo)

(Stock photo)

Some healthcare staff in the UK have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have Covid-19, unless they are in the emergency department and wearing full protective equipment (PPE).

An article in a medical journal outlining these guidelines has been circulated among Irish GPs by the Irish College of General Practitioners.

'The BMJ' outlines how guidance from the University Hospitals Birmingham NHS Foundation Trust states that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a "shockable" rhythm.

But if this fails to restart the heart "further resuscitation is futile".

If a patient with suspected Covid-19 is in cardiac arrest they should be given cardiac compressions and be ventilated only if they are in the emergency department and the person attending them is wearing aerosol generating procedures (AGP) PPE.

That means wearing an FFP3 mask, full gown with long sleeves, gloves and eye protection.

The advice rests on the premise that performing cardiac compressions would risk virus particles being released into the air that could infect staff.

In an email to staff, Nick Crombie, associate medical director and trauma anaesthetist at the trust, acknowledged that there was unease about the new policy.

But he said that the pandemic was a major situation that required action that would be unthinkable in different circumstances.

"Every patient we see could potentially not only harm us but, remotely, our families.

"In this situation, we are the front line and we have to get into the mindset of putting our own safety first. We have to be safe," he said.

"This is not about lack of PPE or money."

The Birmingham guidance differs from Resuscitation Council UK's advice only in the number of shocks that are recommended - one instead of three.

The council's guidance also says that staff should put on full PPE for aerosol generating procedures before initiating CPR in patients with Covid-19.

The picture is complicated by the latest advice from the Department of Health and Social Care for England and public health bodies in England, Wales, Scotland and Northern Ireland, updated on March 27.

This says that chest compressions and defibrillation - as part of resuscitation - can be carried out without full PPE "while awaiting the arrival of other personnel who will undertake airway manoeuvres".

Irish Independent