Overcoming Fears to Save Lives: COVID-19 and the Threat to Bystander CPR in Out-of-Hospital Cardiac Arrest.
Overcoming Fears to Save Lives: COVID-19 and the Threat to Bystander CPR in Out-of-Hospital Cardiac Arrest.
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DOI：
10.1161/circulationaha.120.048909
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发表时间：
2020-09-29
期刊：
影响因子：
37.8
通讯作者：
Perman SM
中科院分区：
文献类型：
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作者：
Perman SM
2020年9月29日发行。2020; 142：1233-1235. DOI：10.1161/ARATIONAHA。120.048909 1234无疑会看到毁灭性的影响。来自华盛顿的数据显示，在大流行期间，紧急医疗服务应对的心脏骤停患者中有10%为COVID-19阳性。假设在没有个人防护装备的情况下，传播率为10%，在治疗100名患者后，1名救援人员可能会被感染。4在COVID-19期间，OHCA的发生率一直在增加，但这些心脏骤停可能主要不是由病毒引起的，限制旁观者复苏措施以保护救援人员无疑会导致心脏骤停导致的死亡，而不一定是COVID-19。美国心脏协会发布了COVID-19期间基本生命支持的临时指南。5.公众先前对心脏骤停患者的bCPR提出了建议，2010年，从基本生命支持算法中删除了人工呼吸，转而采用仅用手的方法。话虽如此，即使是只用手的心肺复苏术也会导致呼吸道飞沫雾化，并可能导致严重急性呼吸综合征冠状病毒2的污染物传播。尽管证据不足，但目前的COVID-19建议包括在进行bCPR时要谨慎。当对无反应的人进行心肺复苏术时，应尽一切努力用布覆盖心脏骤停者的面部，以尽量减少呼吸道飞沫的散布，如果可能的话，救援人员也应使用面部覆盖物以增加保护。不应提供人工呼吸，救援人员应尽快实施符合指南的胸外按压和放置自动体外除颤器。其他救援人员应保持一定距离，
September 29, 2020 Circulation. 2020; 142: 1233–1235. DOI: 10.1161/CIRCULATIONAHA. 120.048909 1234 will undoubtedly see a devastating effect. Data from Washington showed that in the midst of the pandemic,≈ 10% of individuals with cardiac arrest responded to by emergency medical services were COVID-19 positive. Assuming a transmission rate of 10% without personal protective equipment, after treating 100 patients, 1 rescuer may become infected. 4 Rates of OHCA have been increasing during COVID-19, but those arrests may not be caused primarily by the virus, and limiting bystander resuscitative measures to protect the rescuer will undoubtedly result in death caused by cardiac arrest, not necessarily COVID-19.The American Heart Association has issued an interim guideline on basic life support during COVID-19. 5 Recommendations previously endorsed bCPR by the public for individuals with cardiac arrest, and in 2010 rescue breaths were removed from the basic life support algorithm in favor of a hands-only approach. That being said, even hands-only CPR can result in aerosolization of respiratory droplets and potential fomite transmission of severe acute respiratory syndrome coronavirus 2. Although evidence is sparse, current COVID-19 recommendations include taking caution while still performing bCPR. When CPR is performed on an unresponsive person, all efforts should be made to cover the face of the individual with cardiac arrest with a cloth to minimize the dispersion of respiratory droplets, and the rescuer also should have a face covering if possible for increased protection. Rescue breaths should not be provided, and the rescuer should administer guidelineconcordant chest compressions and placement of an automated external defibrillator as soon as possible. Additional rescuers should remain at a distance, away