Giving CPR during Coronavirus: what you should know

Correctly and safely performing CPR in an emergency is a vital skill we should all learn

The way we live our lives has changed significantly over the past year. We are each aware of the responsibility to protect our health and that of the wider community, while businesses have adopted measures to ensure that staff and customers alike can continue engaging with operations while maintaining a social distance. We’ve all shifted our lives around COVID-19, and even developed coping mechanisms for the isolating effects of lockdown. However, even after a year, there are circumstances that some of us might not have considered could be affected by the pandemic.  

Among these is the impact on our ability to administer lifesaving measures. Correctly and safely performing cardiopulmonary resuscitation (CPR) in an emergency is a vital skill we should all learn, but the coronavirus has meant that we need to limit our contact with others, particularly when it comes to the potential for aerosol spread. It’s a difficult balance to achieve — how do you undertake your duty to help someone in need while at the same time limiting the risk of additional exposure and transmission of a virus that has already killed millions of people in the U.S. alone?   

We’re going to take a look at the areas you need to take into consideration both before and during the need to provide CPR. What should factor into your decision to assist? How can you better prepare for the responsibility of saving a life in a time of public health crisis? 

Safety standards

It’s only natural that there’s some hesitation to administer CPR during this time. After all, many of us have developed reluctant reactions to the prospect of shaking hands or even hugging others! Though we know that the application of CPR could save a life, we still have to find that happy medium between effective assistance and sanitary contact. 

Some best practices in this area include:  

• Reduce exposure

The American Heart Foundation has recently issued interim guidelines on performing resuscitation. One of the primary aspects is taking steps to limit the potential for exposure. Those applying CPR should wear personal protective equipment (PPE) — mask, face shield, and gloves if possible. It is also important to keep those not actively involved with CPR away from the immediate vicinity.

• Maintain cleanliness

Before beginning to administer assistance, be sure to wash or use sanitizer on your hands. Time is often a factor, but taking a few moments to sanitize can limit your potential for transmission. Immediately following administration, simply squirting some sanitizer isn’t enough — you need to commit to full and correct hand washing. Go through the full steps of cleaning with soap for at least 20 seconds, working the soap between each of your fingers, before rinsing and drying. 

• Avoid mouth-to-mouth

When approaching any emergency scenario, it’s always important to take a moment to calmly consider what the most appropriate action for the circumstances are — this is about your safety as much as the person needing assistance. In seeking to avoid exposure to COVID-19, consider whether it is medically necessary to apply mouth-to-mouth. Will application of chest compressions alone be sufficient until help arrives? It can also be wise to cover the victim’s mouth and nose with a mask or cloth. It’s also important to consider whether the patient is able to safely receive chest compressions alone — some who have had open-heart surgery or stents fitted can risk further damage. In these cases, administration of an automated external defibrillator (AED) is recommended, if it can be performed safely. 

Legal ramifications

If you feel that the risk of potential infection during CPR is too great, it’s important to note that 49 states don’t legally require those trained in first aid to apply resuscitation techniques. The only exception is Vermont, which requires anybody to assist in an emergency, but this is on the proviso that you can do so without danger to yourself. This suggests that if you’re able to perform CPR, while wearing PPE, you must legally do so. This law applies even if you’re untrained, and have to rely on an app to help you through the process. In general, Good Samaritan laws will also prevent you from being sued if you inadvertently cause harm while voluntarily providing assistance.  

In the workplace, the Occupational Safety and Health Administration (OSHA) have made it a legal requirement in certain industries for a member of staff to be trained to apply first aid where a hospital or infirmary isn’t in the immediate facility. This puts additional legal pressure on business owners at a time when it’s also vital to also prevent exposure among staff and by extension their families and the wider community. However, while this legislation still applies during the pandemic, OSHA has released guidance that employers should provide workers with respiratory protection for use when performing or while present for aerosol-generating procedures such as CPR.    

Keeping up to date

CPR administered by someone who hasn’t received full training can be very dangerous. That said, taking a first aid course is never a one-and-done situation. Even after initial training, it’s important to keep your skills updated and educate yourself on any new protocols and life-saving innovations that have been introduced. 

Contact certification providers and enquire about whether their training has extended to include COVID-19 resuscitation techniques. The Centers for Disease Control and Prevention (CDC) released recommendations that include reviewing the situation to establish whether the aerosol-generating procedures can be undertaken in isolated rooms or areas, which PPE should be applied before CPR, and the need to assess for potential signs of COVID-19. In non-medical settings — such as stores, factories, and schools — this has to extend to how the presence of workers, consumers, and pupils can create additional exposure risks. Such locations are also less likely to have access to the most robust PPE on the market, and precautions beyond the CDC guidelines must be taken. These are all skills beyond the usual educational remit of CPR certification, but as they may be necessary for some time, you need to ensure training providers include these elements as part of the curriculum.    

Online courses can also be the most educational option for the time being — particularly if you’re just seeking to refresh your knowledge. This limits unnecessary exposure to others, not to mention avoiding contact with apparatus such as mouth-to-mouth dummies. Assess the level of training that is most suitable for your circumstances and reach out to providers to understand how you can best keep yourself and others safe. 

Conclusion 

Performing CPR is a grave responsibility. During this pandemic, you not only have the weight of saving lives on your shoulders, you also need to consider the potential transmission implications. By following sanitary procedures, reassuring yourself of your legal protections, and keeping well trained, you can help ensure that your skills can both address emergencies, and keep you and the community COVID safe. 

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