How to Perform CPR During the COVID-19 Pandemic

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Categories: Knowledge Base, Life Saving Advice

The American Heart Association (AHA) has issued new professional and bystander guidelines for how to perform CPR amid the COVID-19 outbreak. The full guidelines can be found at cpr.heart.org. During a time when social distancing measures are paramount, we must do everything we can to preserve our own health and well-being, even as we work to save the life of someone else. For anyone familiar with CPR procedures, the good news is that the modifications are fairly basic and easy to implement.

How to Perform Adult CPR During the COVID-19 Pandemic

If an adult goes into cardiac arrest, the AHA now recommends the following:

  1. Call 911 and retrieve an automated external defibrillator (AED) if it’s available. If another person is nearby, have them retrieve the AED while you call 911. If you suspect that the patient has COVID-19, let the 911 operator know.
  2. Cover your mouth and nose with a face mask. If you don’t have one, you can use any cloth fabric.
  3. Cover the patient’s mouth and nose with a towel or cloth to prevent airborne or saliva-based COVID-19 contamination.
  4. Perform chest compressions on the patient.
    1. Place both hands firmly at the center of the chest and push down at a rate of 100 to 120 beats per minute (follow the beat of Stayin’ Alive) and a depth of 2 to 2.4 inches.
    2. Let the chest rise fully between each compression.
  5. Turn on the AED as soon as it becomes available. Follow the voice instructions to treat the patient until help arrives.

If you don’t have an AED available, continue the CPR chest compressions until emergency services arrive. After you finish all emergency procedures, wash or dispose of the cloth that was placed over the patient’s mouth and nose. Then wash your hands thoroughly for at least 20 seconds with soap and water.

How to Perform Child CPR During the COVID-19 Pandemic

Child CPR is a bit different. The AHA still recommends a combination of chest compressions and rescue breathing because compressions alone aren’t as effective on pediatric patients. If a child goes into cardiac arrest, the AHA advises the following:

  1. Call 911 and retrieve an automated external defibrillator (AED) if it’s available. If another person is nearby, have them retrieve the AED while you call 911. If you suspect that the patient has COVID-19, let the 911 operator know.
  2. Perform 30 chest compressions.
    1. If the patient is a child (age 1 or older): Place one to two hands firmly at the center of the chest and push down at a rate of 100 to 120 beats per minute (follow the beat of Stayin’ Alive) and a maximum depth of 2 inches.
    2. If the patient is an infant (under 1 year): Place two fingers firmly at the center of the chest and push down at a rate of 100 to 120 beats per minute and a depth of 1 ½ inches.
  3. Perform 2 rescue breaths. To complete a rescue breath:
    1. Open the child’s airway by tilting the head back and lifting the chin forward and up.
    2. Pinch the child’s nose and place your mouth over the child’s mouth to create an airtight seal.
    3. Breathe into the child’s mouth for a full second. You should see the chest rise. If you don’t see the chest rise, make sure the airway is open and that the nose is closed.
  4. Perform four more cycles of 30 compressions and 2 breaths.
  5. Turn on the defibrillator.
  6. Determine if the defibrillator has a child setting—this is only necessary for children under 8 years old or 55 pounds.
    1. Look for a “Child” button on the device or a set of pediatric pads in the AED case. Attach the pads if available.
    2. If no child-specific features or accessories are found, use the standard adult setting but place one AED pad on the center of the child’s chest and one on the center of the child’s back.
  7. Follow the voice instructions to treat the patient until help arrives.

If you don’t have an AED available, continue CPR until emergency services arrive. When you finish, wash your hands thoroughly for at least 20 seconds with soap and water.

If you performed rescue breaths and you suspect that the child has COVID-19, speak to your doctor right away. They should be able to provide you with a referral for COVID-19 testing.

The Link Between Cardiac Arrest & COVID-19

There appears to be a correlation between COVID-19 and cardiac arrest risk. One study from China looked at 416 patient case studies and found that 19% showed signs of heart damage. Some COVID-19 sufferers have also died not from respiratory complications but from cardiac arrest resulting from the heart damage.

This is yet another reason why it’s so important to understand CPR best practices and be prepared to administer lifesaving defibrillation if necessary.

How to Know if a Patient Is Experiencing Cardiac Arrest

As stay-at-home orders remain largely in effect, an out-of-hospital cardiac arrest is most likely to occur inside the home. If it happens under your watch, it’s up to you to recognize the signs that the patient needs CPR and defibrillation. Start by shouting loudly at that patient. Listen for any response.

A cardiac arrest sufferer:

  • Will be unresponsive
  • Will not be breathing (though they may be gasping in about 40% of cases)
  • Will not have a heartbeat or a pulse
  • Will be unconscious

If the patient exhibits these signs, begin CPR and defibrillation immediately.

How to Prepare for a Cardiac Emergency While Staying Indoors

COVID-19 presents new challenges for healthcare. Hospitals and emergency services are over-extended in certain regions, and cities like New York are denying hospital treatment to cardiac arrest sufferers who can’t be revived on the scene.

If you are at risk for cardiac arrest, or if you live with someone at risk for cardiac arrest, the best way to prepare for an emergency is to invest in an automated external defibrillator. You can find new FDA-approved AED devices for as little as $1,200. There are also recertified defibrillators available that cost approximately half the price.

The biggest advantage of having an AED is that it allows you to take action immediately in an emergency. You don’t have to wait for the ambulance to arrive with lifesaving medical equipment. CPR is important, but research shows that CPR combined with defibrillation can improve a patient’s chances of survival by over 60%. Every minute matters in a cardiac arrest situation, and that’s why it’s so important to act swiftly.

So brush up on your CPR, invest in a quality defibrillator, and know that you’re prepared for whatever comes your way—even in the face of a global pandemic.