COVID-19 and First Aid/ CPR/ AED

Since the onset of the COVID-19 pandemic, reasonable concerns were aroused regarding the safety of healthcare providers, as well as people trained in First Aid, CPR/AED.

New protocols that will ensure the safety of people administering first aid or CPR have been generated, geared to protecting rescuers from COVID-19 while still allowing them to assist persons in need.

The protocols presented below are intended for people who are not trained healthcare professionals.

The basics on COVID-19

The protocols developed for the protection of people who are not healthcare professionals will be best understood after a quick overview of the basic profile of the SARS-CoV2 virus and how it can be transmitted from person to person.

Current and ongoing research indicate that the SARS-CoV2 virus is transmitted from person to person via respiratory droplets.

This means that people in close proximity (i.e., a distance of less than 6 feet) are likely to enable transmission of the virus. When an infected person coughs, sneezes, talks or yells these droplets that are emitted from their mouth can then be inhaled into the lungs of others in proximity through their own mouth or nose.

There is some indication that infectious droplets on surfaces that other people touch might also lead to transmission of the virus, through research is still ongoing and knowledge of the virus is still being acquired.

CPR and COVID-19

Though there haven’t been any studies or scientific consensus on whether administering CPR can lead to the transmission of COVID-19, considering the mechanics of the virus it is reasonable to assume that infectious droplets will be emitted from the mouth of an infected victim when performing chest compressions and when coming into close contact for the other parts of the CPR protocol, such as rescue breaths.

Using Proper PPE when performing CPR

The recommended PPE to be used to protect yourself from COVID-19 includes:

· Respiratory protection (e.g., a N-95 mask or other CDC approved face coverings)

· Eye Protection

· Disposable gloves

· Disposable isolation gown (if available)

PPE worn on the victim receiving CPR:

· Respiratory protection (e.g., a N-95 mask or other CDC approved face coverings)

· Disposable gloves, if available

If there is only one set of PPE, especially only one face mask, it is best to have the victim wear it, rather than yourself.

If you are giving CPR to a family member, it might be that you have already been in close contact with them for a long time, so protection may not be necessary if that is the case.

Changes in the CPR protocol

Though giving rescue breaths in conjunction with the chest compressions has been shown to yield better results that simply giving chest compressions, during the COVID-19 pandemic rescue breaths are not recommended.

Additionally:

· When checking for breathing, the rescuer should look, but not hear nor feel for the presence of the victim’s breathing to reduce exposure.

· When administering CPR for cardiac arrest, give chest compressions only. Keep in mind that giving chest compressions only CPR is a lot better than no CPR!

· For cardiac arrests that have occurred after breathing issues (such as drowning, drug overdose, or young children and infants) the standard CPR protocol with the rescue breaths may be more beneficial, but it is up to the rescuer to decide whether compressions-only CPR will be administered due to COVID-19 or not.

Use of an AED, chest compressions, and calling 911 are still part of the CPR protocol and should be followed for all victims regardless of COVID-19.

Use of the AED

Keep in mind that use of the AED (i.e., defibrillation) has not been shown to produce more droplets or aerosols from the victim. AED use should be applied in all cardiac arrests regardless of COVID-19 issues.

The rescuer should wear gloves if available, and after use the AED should be cleaned with disinfectant.

After First Aid Care

After first aid care has been administered, proper procedures for disinfection and cleaning should take place to protect from COVID-19.

1. Do NOT take off your PPE.

2. While still wearing your PPE, clean all surfaces that touched the victim.

3. With care not to touch outward surfaces of your PPE as much as possible, remove and dispose your PPE.

4. Take off and wash dirty laundry without shaking it to avoid dispersing the virus in the air. If you can’t immediately wash the laundry, store it in a plastic, sealed bag or container.

Use solutions with bleach or 70% alcohol for hard surfaces, or other EPA-approved household disinfectants.

Follow instructions for cleaning soft or porous surfaces, using the warmest possible water and the strongest possible solutions and EPA-approved, appropriate detergents for disinfecting such surfaces. Let them dry completely.

After caring for a person with confirmed COVID-19, you should monitor yourself for the following days. If you experience symptoms such as sore throat, shortness of breath, or coughing, contact your health provider immediately.