Recommendations for Cardiopulmonary Resuscitation (CPR) of patients with suspected or confirmed COVID-19

Timerman, Sérgio; Guimarães, Hélio Penna; Rodrigues, Roseny dos Reis; Corrêa, Thiago Domingos; Schubert, Daniel Ujakow Correa; Freitas, Ana Paula; Neto, Álvaro Rea; Polastri, Thatiane Facholi; Vane, Matheus Fachini; Couto, Thomaz Bittencourt; Brandão, Antonio Carlos Aguiar; Giannetti, Natali Schiavo; Carmona, Maria José Carvalho; Timerman, Thiago; Hajjar, Ludhmila Abrahão; Bacal, Fernando; Queiroga, Marcelo

Abstract The care for patients suffering from cardiopulmonary arrest in a context of a COVID-19 pandemic has particularities that should be highlighted. The following recommendations from the Brazilian Association of Emergency Medicine (ABRAMEDE), the Brazilian Society of Cardiology (SBC) and the Brazilian Association of Intensive Medicine (AMIB) and the Brazilian Society of Anesthesiology (SBA), associations and societies official representatives of specialties affiliated to the Brazilian Medical Association (AMB), aim to guide the various assistant teams, in a context of little solid evidence, maximizing the protection of teams and patients. It is essential to wear full Personal Protective Equipment (PPE) for aerosols during the care of Cardiopulmonary Resuscitation (CPR) and it is imperative to consider and treat the potential causes in these patients, especially hypoxia and arrhythmias caused by changes in the QT interval or myocarditis. The installation of an advanced invasive airway must be obtained early and the use of High Efficiency Particulate Arrestance (HEPA) filters at the interface with the valve bag is mandatory; situations of occurrence of CPR during mechanical ventilation and in a prone position demand peculiarities that are different from the conventional CPR pattern. Faced with the care of a patient diagnosed or suspected of COVID-19, the care follows the national and international protocols and guidelines 2015 ILCOR (International Alliance of Resuscitation Committees), AHA 2019 Guidelines (American Heart Association) and the Update of the Cardiopulmonary Resuscitation and Emergency Care Directive of the Brazilian Society of Cardiology 2019.