The coronavirus pandemic has affected people widely with this severe illness; in closely all areas of life. Health systems have taken utmost pressure with the patient numbers and the high complications resulting from the disease. The delivery of Cardiopulmonary Resuscitation has been at the receiving end of the pandemic. Not only has the condition changed the technicality of the procedure but also the CPR training processes.
The American Heart Association constantly carries out heart-related research and publishes guidelines based on findings. Since the outbreak of Covid 19, caring for persons with heart disease has been based on research and scientific findings. Handling of opioid emergencies and early CPR by bystanders.
CPR in COVID-19 patients is associated with multiple aerosol-generating procedures (bag-mask ventilation), including chest compression, positive pressure ventilation, and airway manipulation.
Changes in the Delivery of CPR
Cardiopulmonary Resuscitation is a critical lifesaving procedure for cardiac arrest patients. However, high aerosol-generating can put first aid responders and health workers at an increased risk of infection.
Some of the factors are:
- CPR involves teams working closely together
- The procedure is high aerosol-generating
- Cardiac arrest exerts a lot of pressure on those involved and could lead to compromise to recommended precautions standards.
Covid-19 patients are at risk for developing cardiopulmonary arrest and cardiorespiratory problems. If a patient experiences these issues, they will require basic life support. In some cases, advanced life support may also be necessary. The decision to provide CPR will be based on factors such as the victim's age, underlying illnesses, and other health conditions, which will determine the victim's chances of survival.
New Guidelines for Performing CPR to COVID-19 Patients
It is vital to ensure the rescuer's safety while providing the utmost care to the victim. Therefore, the American heart association, alongside other bodies, has provided a new set of guidelines when performing CPR on Covid-19 victims:
- With the prevalence of Covid-19, health workers are reluctant to provide CPR to cardiac arrest victims. However, it is essential to note that not every out of hospital cardiac arrest victim is infected with Covid-19.
- For essential life support, prioritize hands-only CPR – Hands-only CPR is safer. However, health workers should wear full PPE (personal protective equipment).
- First, cover the victim's mouth and nose with a cloth or towel when performing CPR. In hospitalized care, Covid-19 patients who experience cardiac arrest should be resuscitated and defibrillated.
- Use the AED as soon as it is available to improve cardiac arrest outcomes. Studies show that the AED doesn't increase aerosol generation.
- Don't leave anything at risk with the use of personal protective equipment. PPE is critical for health workers or rescuers taking care of Covid-19 patients. Before accessing the scene, all rescuers should wear the recommended PPE per the institutional guidelines. These include gowns, gloves, eye protection, and respirators.
- Mechanical CPR devices should be used instead of manual machines as this will reduce the number of professionals required to attend to a specific patient.
- The health care personnel performing resuscitation should be minimized, and those entering isolation rooms. It helps in the reduction of the rate of exposure to the virus.
- The American Heart Association recommends that doors remain closed during Resuscitation efforts to minimize the spread of the virus to the surrounding space.
- New health care workers arriving at the scene should be made aware of the Covid-19 status of the victim. Communication should be made with all health workers working in the facility. When calling for emergency response teams, the responder should also notify them if the patient has been found to have the infection.
- To reduce aerosolizing effects, intubated patients should remain in mechanical ventilators with high-efficiency particulate air filters (HEPA). It helps reduce the impact of aerosolization and maintains a closed circuit.
- The ventilation should be adjusted to pressure control mode. The fraction of inspired oxygen (FiO2) should also be adjusted to 0.1. The pressure should also be adjusted to allow for the necessary chest rise in adults to 6Ml/kg and 4-6Ml/kg for neonatal.
- Intubation procedures are highly aerosol-generating. The health care provider recommended that the health care provider use a cuffed endotracheal tube connected to a ventilator with a HEPA filter in the exhaled gas path and an inline suction catheter. The resulting circuit is safer and less likely to generate aerosol.
Decision-making process on the delivery of CPR to Covid 19 victims
The decision to continue or stop Resuscitation is a challenging one. At some point, healthcare providers have to make this critical decision. A lot of teamwork is required in the CPR procedure. A single case of CPR might draw attention from other patients. The covid-19 pandemic has increased the need for CPR stretching health facilities and healthcare workers beyond their capacity. Healthcare workers should assess the chances of survival of the victim as they try to determine whether or not to continue the resuscitation process.
It is essential to address care needs with the patient and family. Institutions should provide guidelines and procedures to assist healthcare personnel in deciding when to stop Resuscitation for Covid- 19 patients. The policies should be based on the risk factors and the chances of survival. They should be communicated to the victim's family beforehand.
Shift to Online CPR certification due to Covid 19
At some point, people had to shift to online learning platforms due to the challenges posed by the disease. Luckily, CPR training is accessible through online classes. Since coronavirus disease -2019 (covid-19) can be contracted through close contact, physical classes are discouraged during this covid-19 period. It is hard to maintain social distancing during classes in physical CPR training processes. During practical sessions, the people taking physical training sessions for CPR might share some helpful equipment, which increases the risk of cross-infection.
As a result of the Covid 19 outbreak, CPR certification became an essential requirement for the survival of victims in severe conditions. In addition, there is a need to have more CPR-certified professionals due to the increasing cases of sudden cardiac arrest. Cardiac arrest can occur anywhere when least expected. It can occur at home, to a family member, or to a stranger on the street. As we saw earlier, Covid-19 has increased the cases of sudden cardiac arrest by half. It becomes, therefore, critical for everyone to acquire CPR skills.
Due to the need for social distancing, the Covid-19 pandemic has closed schools and colleges worldwide. This has resulted in a dramatic change in the procedures of acquiring knowledge. There has been a significant shift to digital learning whereby learners take their courses remotely on online platforms. Unlike in the past, people have now started to appreciate the value of online learning platforms.
Even before the coronavirus pandemic, many colleges were already adopting online learning, with the 2019 online global education investment hitting a high of $18.66 billion. Experts project that, by 2025, this figure will increase by over $330 billion. This growth is accelerated by Covid-19, which has led to remarkable development in e-learning software, online conferencing tools, virtual tutoring tools, and language apps. Online CPR training is one of the courses that has benefited from this growth.
All in all, online CPR certification is quite beneficial. It is highly flexible, more so for persons with busy schedules. Besides, learners acquire the same level of skills and knowledge as the physical classes without leaving the comfort of their homes. Additionally, online CPR classes are relatively cheaper as compared to in-person training.
Need for CPR skills amid Covid 19 crisis
CPR is a life saving technique that is now quite basic. People critically ill with Covid-19 are more prone to cardiac arrest. Statistics reveal that in-hospital and out-of-hospital cardiac arrest cases have increased by over 50% worldwide since the outbreak. As Covid-19 future of Covid 19 remains uncertain, it is best to know how to safely perform CPR while protecting yourself from exposure to the virus. Studies show that it is possible to contract Covid-19 while performing CPR on an infected patient. The CPR process is highly aerosol-generating and should be performed with proper PPE.
Covid-19 has been linked to tachyarrhythmia and bradyarrhythmia, which are likely to cause sudden cardiac arrest and death. They are also common in ICU patients with Covid-19. However, the patients still have a chance of survival after the cardiac arrest when proper treatment is offered.
Covid-19 has increased the need for CPR certification. Statistics show that CPR-certified persons are way below the recommended number. Whenever a case of cardiac arrest occurs, the chance of survival of the victim depends on the availability of a CPR-certified person. CPR training is available on online platforms whereby various accredited institutions provide the certification course. Cardiac arrest can occur anywhere and to anyone. CPR skills make you an asset to your family, colleagues, and strangers.
CPR classes are the best way to acquire CPR skills. Without the necessary training, pulling together the essential confidence to save a life would be challenging. The quality of CPR provided determines the chances of survival of the victim. CPR classes also offer knowledge on recognizing the signs of cardiac arrest early enough to give the required assistance and save the victim's life.
Most organizations require CPR certification, especially during this Covid- 19 pandemic. CPR skills are fundamental not only for healthcare workers but also for other professions. The skills apply in CPR are easy to follow, even for non-professionals. The training is also open for anyone interested in joining, regardless of their levels of education and age.