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| GUIDELINE |
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| Year : 2020 | Volume
: 9
| Issue : 1 | Page : 3-5 |
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Iranian heart association task force on cardiopulmonary resuscitation guidelines on the COVID-19 outbreak
Somayyeh Barati1, Khazar Garjani2, Pooya Payandemehr2, Ziae Totonchi1, Mohammad Esmail Zanganehfar1, Pardis Sadeghipour3, Ahmad Amin1, Vahid Akhondi1, Amir Mohamad Javadi4, Parham Sadeghipour5, Mohammadreza Baay1
1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Internal Medicine, Firoozgar Hospital, Iran University of Medical Science, Tehran, Iran
4 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
5 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| Date of Submission | 05-Apr-2020 |
| Date of Decision | 06-Apr-2020 |
| Date of Acceptance | 07-Apr-2020 |
| Date of Web Publication | 24-Apr-2020 |
Correspondence Address:
Dr. Mohammadreza Baay
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave., Tehran 1996911101
Iran
 Source of Support: None, Conflict of Interest: None  | 3 |
DOI: 10.4103/rcm.rcm_10_20
How to cite this article:
Barati S, Garjani K, Payandemehr P, Totonchi Z, Zanganehfar ME, Sadeghipour P, Amin A, Akhondi V, Javadi AM, Sadeghipour P, Baay M. Iranian heart association task force on cardiopulmonary resuscitation guidelines on the COVID-19 outbreak. Res Cardiovasc Med 2020;9:3-5 |
How to cite this URL:
Barati S, Garjani K, Payandemehr P, Totonchi Z, Zanganehfar ME, Sadeghipour P, Amin A, Akhondi V, Javadi AM, Sadeghipour P, Baay M. Iranian heart association task force on cardiopulmonary resuscitation guidelines on the COVID-19 outbreak. Res Cardiovasc Med [serial online] 2020 [cited 2021 Mar 7];9:3-5. Available from: https://www.rcvmonline.com/text.asp?2020/9/1/3/283155 |
| Necessity | |  |
Healthcare precautions during an epidemic constitute a formidable challenge that requires profound consideration. For instance, some common procedures for cardiopulmonary resuscitation (CPR) known as aerosol-generating procedures (AGPs) highly increase the risk of transmission and infection with COVID-19 in healthcare workers and treatment environments.[1]
Treating patients in need of CPR and protecting them against COVID-19 while preventing the infection from spreading to other patients and their relatives, as well as the hospital staff, require an accurate set of predictions and preparations.[1],[2]
| Objectives | | |
The guidelines presented herein aim to inform healthcare workers of the prerequisites and considerations to be taken heed of during and after CPR until the end of the COVID-19 pandemic. [Table 1] the standard CPR guidelines seeking to enhance the conduct of safe CPR by all healthcare workers (if need be), and [Table 2] contains recommendations on the conduct of more secure intubation by anesthesia specialists, residents, and technicians. | Table 1: Resuscitation guidelines for patients with known or suspected coronavirus disease 2019
Click here to view |
| Target Audience | | |
The exigencies of epidemic-specific care necessitate swift, but calculated changes. To that end, the present guidelines endeavor to impart the significance of such objectives to all healthcare workers involved in CPR, whether directly (e.g., physicians and nurses) or indirectly (e.g., nurse aides, technicians, infection control committee, hospital housekeepers, and security staff).
| Utility | | |
- All patients presenting with cardiorespiratory arrest to the emergency departments should be considered suspicious cases and be administered CPR on the basis of the present guidelines
- All patients presenting with cardiorespiratory arrest to health centers, clinics, and similar treatment facilities should be considered suspicious cases and be administered CPR on the basis of the present guidelines
- All patients needing CPR in specific or suspected wards for COVID-19 should be resuscitated in accordance with the present guidelines
- All patients needing CPR with suspected symptoms for COVID-19 in other hospital wards should be resuscitated in accordance with the present guidelines.
| Additional Suggestions | | |
- We urge that different centers, commensurate with their equipment and human resources, apply the maximum principles of the present guidelines
- We recommend that treatment centers' directors attach due significance to the presentation and teaching of the present guidelines, as well as other essential guides and directives, to their personnel
- We suggest that the main table of the present guidelines be printed and placed in full view of the staff involved in the CPR process
- We advocate “prone CPR” provided that CPR personnel have the benefit of previous experience in this regard and the situation is appropriate with a view to lessening the risk for aerosol transmission. In brief, the patient is positioned prone for cardiac compression to be applied at the midthoracic vertebrae (T7 level), between the two scapulae. Compression can be bolstered with a stiff board placed between the patient's chest and the mattress. If defibrillation is needed, one pad should be placed at the left midaxillary line and the other on the right scapula.
| Other Essential Guides | | |
Next to the present guidelines, we recommend that the following guides be available in healthcare centers in order that necessary educational programs can be devised:
- Standard CPR guidelines
- Instructions for wearing and removing personal safety equipment
- Handwashing tutorials.[6]
Review Committee
Majid Haghjoo, MD; Mohammad Jalili, MD; Majid Kyavar, MD; Alireza Mahoori, MD; Majid Maleki, MD; Feridoun Noohi, MD; Mohamad Mehdi Peighambari, MD; Seyed Abdolhosein Tabatabaei, MD
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | |
| 2. | |
| 3. | World Health Organization. Report of the WHO-China Joint Commission on Coronavirus Disease 2019. World Health Organization; 2020.  |
| 4. | |
| 5. | AHA Guidance for CPR, Emergency CV Care Amid COVID-19 Medscape; 23 March, 2020. |
| 6. | Orser BA. Recommendations for endotracheal intubation of COVID-19 patients. Anesthesia Analgesia 2020;130:5. |
[Table 1], [Table 2]
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