CPR during the COVID-19 Pandemic

We all know that CPR (cardiopulmonary resuscitation) saves lives. The American Heart Association states immediate CPR can double or triple chances of survival after cardiac arrest. But the contagious nature of COVID-19 poses new risks for those doing CPR.

Have you discussed your CPR wishes with your family? If you test positive for COVID-19 or suspect you may have it, do you want CPR performed on you?

You should discuss your wishes with loved ones before the need for CPR arises. You can complete an advance directive to make it clear how you want to receive care.

The American Medical Directors Association (AMDA) has released important instructions for health care employees about CPR. The success of CPR is low in patients who live in nursing homes. CPR causes risk of getting coronavirus. That is why additional steps are needed when health care employees perform CPR during this illness.

These 5 steps will be completed if CPR is needed for any person who lives in a nursing home that has or may have COVID-19:

1. Employees will put on PPE, personal protective equipment, BEFORE starting CPR.

2. Employees will spread a clear plastic sheet over the patient including the patient’s head.

3. Only the minimum number of essential healthcare employees with PPE will be allowed in the room while CPR is completed.

4. If ventilation is needed, employees will use a bag-valve mask UNDER the plastic sheet. If N95 respirator masks are not available, hands-only CPR without ventilation will be completed until the ambulance arrives.

5. The door to the patient’s room will be closed before CPR is started. Other patients will be moved away from the area. This will lower risk and contact with other patients during CPR.

During this illness, you may think of new questions about care at end of life. Our goal is to help you talk with your family, especially if you or a loved one lives in a nursing home.

It is important to think about this before CPR is needed. Don’t delay. Early discussion of advance directives and code status will help to make sure that your goals are met.

Rachel Choate, FNP

OptumCare and CoxHealth at Home Advanced Practice Clinician

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