Hands-Only Bystander CPR Advised During Pandemic

By Carolyn Christ

July 21, 2020

(Reuters Health) - Hands-only cardiopulmonary resuscitation (CPR) carries a low risk of transmitting the coronavirus and bystanders who witness a cardiac arrest during the pandemic should not be afraid to perform it, an emergency medicine physicians writes in Circulation.

Hands-only CPR carries a low risk of transmitting the virus, and public health officials should continue to encourage people to save lives with CPR, said Dr. Sarah Perman of the University of Colorado School of Medicine in Aurora.

"It is incredibly important for us to discuss the pandemic as a real threat to bystander CPR," she told Reuters Health in an email.

"The general population are watching news programs showing medical personnel in protective equipment, yet when a medical emergency occurs out in public, they have none of the same resources," she said. "It is important to discuss what the threat is to the public and how they can protect themselves."

Perman called bystander CPR an "essential" and "altruistic" strategy that saves the lives of those who suffer a cardiac arrest in public. At the same time, people may be wary about coming into close contact with others, especially strangers, during a time when social distancing is required.

Her paper cites a study from four provinces showing that out-of-hospital heart attacks increased by 58% recently, likely because people were following shelter-in-place orders and not going to hospitals - and bystander CPR decreased by about 16%.

"If we translate similar findings to the U.S. ... we will undoubtedly see a devastating effect," she wrote.

Dr. Michael Sayre, Director of the Emergency Medical Services fellowship at the University of Washington in Seattle, told Reuters Health in a phone interview, "We know that performing bystander CPR saves lives. The effect size is much greater than contracting COVID-19 and dying as a rescuer."

The American Heart Association issued guidelines in April that recommend hands-only CPR and precautions such as covering faces to reduce the spread of respiratory droplets that may carry the coronavirus. Bystanders who are family members and live with the person who has a heart attack have likely already been exposed at home.

"Many more lives would be saved than harmed by continuing to perform bystander CPR, especially if basic safety measures are taken," said Dr. Torben Becker, an emergency medicine physician at the University of Florida in Gainesville, in email to Reuters Health.

Rescuers can wear a mask, which they may already be doing in public to slow the spread of COVID-19, and they can cover the heart attack victim's mouth and nose with a cloth such as a shirt, he added.

SOURCE: https://bit.ly/39d21SI Circulation, online July 10, 2020.