The Heart Foundation of Jamaica (HFJ) is advising members of the public, particularly those trained in cardiopulmonary resuscitation (CPR) to observe the changes in guidelines when administering the procedure in the coronavirus (COVID-19) era.
Speaking at a JIS Think Tank on Thursday (October 22) to mark CPR Week, Director of Emergency Cardiac Care at the HFJ, Dr. Hugh Mark Wong, explained that the changes have come about because of the need to protect persons from being infected with COVID-19.
“The SARS CoV2 virus is so infectious we have had to modify how we approach someone who loses their pulse or collapses,” he said.
“The first thing we must recognise is that the person who is assisting is at risk of getting infection from the [patient] if they are suspected or confirmed (with COVID). Within community spread everybody is suspected,” he noted.
Dr. Wong, who is also head of the Accident and Emergency Department at the Kingston Public Hospital (KPH), pointed out that whereas personal protective equipment (PPE) is available in healthcare facilities, the layperson does not generally have PPE, so one has to do certain manoeuvres to reduce the risk of infection.
This, he explained, involves doing chest compressions-only CPR, because SARS Cov2 is transmitted through the respiratory system.
This is in keeping with the recommendation from the American Heart Association for the layperson to perform chest compressions only.
“Chest compressions-only has been in existence for a long while and has been shown to be effective because once you are doing chest compressions, you are moving blood around and there is passive movement of air in and out of the lungs,” he explained.
“If we are worried about bystanders and ourselves, we should place a face covering lightly over the airway and proceed to do chest compressions only,” he advised.
The face covering, he pointed out, prevents the expiratory gases from the victim from going into the environment and the provider from getting infected.
While CPR is being performed, the provider should call for help from an ambulance or some other agency that can assist, and advise if the patient is suspected to be COVID-positive, so that the necessary precautions can be taken when transporting the patient to the appropriate facility.
Dr. Wong said that if an automated external defibrillator (AED) is available, it should be applied to the patient once CPR is being administered.
“After performing compressions-only CPR and the victim is no longer in danger or has been moved, then we should continue our infection prevention mechanisms by washing our hands and using an alcohol-based hand sanitiser gel if there is no soap and water available,” he noted.
CPR Week is being observed from October 26 to 31 under the theme ‘Surviving with CPR’.