People with Disabilities Can Learn CPR

Learning high-quality CPR can be difficult for those people with disabilities even to a non-disabled people. Doing compressions at a rate of 100-120 BPM, having the strength to push down 2 inches in an adult victim, the endurance to provide CPR for minutes on end, and the ability to kneel for a long period of time. These are all challenges to overcome when learning CPR and it’s the job of the instructor to help students find the strength to overcome these challenges.

But what happens when your student is disabled? What if they are pregnant? Or deaf? Or missing a limb? Or do they simply have bad knees? How do you teach a student CPR who may not believe it is possible themselves? Thankfully, all it takes to save a life using CPR is a willingness to learn and an instructor who is willing to help students adapt to challenges they may face.

Training centers adapt to teach the disabled

Currently, CPR certification is given to students who can properly perform high-quality CPR and accurately use an AED. This means chest compressions of 100 – 120 BPM, a compression depth of 2 inches on adults and a 1/3 of the chest diameter in children, a chest compression fraction of greater than 80%, and no excessive ventilations, according to the American Heart Association. You also must understand how to properly use an AED to shock and revive a victim.

Unfortunately, some people with disabilities may not be able to properly learn and/or perform CPR in the intended way to earn that certification. However, that doesn’t mean there is no hope. Instructors can – and should – adapt their teaching methods to fit the needs of all of their students.

“There is nothing that you cannot modify to make [CPR training] capable for someone to be empowered to do this,” said Tammy Turner, the National Training Center Coordinator, an American Heart Association Training Center, since 2014 and an instructor since 1996.

“You have to have a different way to teach someone who is deaf…someone who is blind are not going to see the visual aspect, but you can paint pictures in their mind. They’re very capable. Also, have CPR training be something they can physically feel.”

Even if someone can’t physically perform the requirements, they can still understand the concepts of CPR. Leadership during an emergency is just as important as those doing the ‘heavy lifting.’ The American Heart Association understands and will grant an Advisor: BLS CPR card to those who perform verbal recognition of the required knowledge and skills for CPR.

Students with disabilities may have some limitations, but many can overcome these potential limitations with technology and creative thinking.

When it comes to technology, accessibility is becoming more important than ever. Large companies like Google, Yahoo, Apple, and others are leading the way to make technology more accessible for those with disabilities, such as smartphone screen magnification or eye tracking for those who are paralyzed

First Support CPR offers CPR classes every Tuesday at 7:15 PM. We offer BLS, First Aid, CPR AED, First Aid CPR AED and Pediatric First Aid CPR AED. We also offer an offsite training. If you have any questions, you can email us at info@firstsupportcpr.com or call at ‪(408) 475-7724‬.

Causes of Cardiac Arrest

Causes of Cardiac Arrest

Cardiac arrest may be caused by almost any known heart condition.

Most cardiac arrests occur when a diseased heart’s electrical system malfunctions. This malfunction causes an abnormal heart rhythm such as ventricular tachycardia or ventricular fibrillation. Some cardiac arrests are also caused by extreme slowing of the heart’s rhythm (bradycardia).

Irregular heartbeats such as these are life threatening.

Other causes of cardiac arrest include:

  • Scarring of the heart tissue – It may be the result of a prior heart attack or another cause. A heart that’s scarred or enlarged from any cause is prone to develop life-threatening ventricular arrhythmias. The first six months after a heart attack is a high-risk period for sudden cardiac arrest in patients with atherosclerotic heart disease.
  • Thickened heart muscle (cardiomyopathy) – Damage to the heart muscle can be the result of high blood pressure, heart valve disease or other causes. A diseased heart muscle can make you more prone to sudden cardiac arrest, especially if you also have heart failure. Learn more about cardiomyopathy. 
  • Heart medications – Under certain conditions, some heart medications can set the stage for arrhythmias that cause sudden cardiac arrest. (Oddly, antiarrhythmic drugs that treat arrhythmias can sometimes produce ventricular arrhythmias even at normal doses. This is called a “proarrhythmic” effect.) Significant changes in blood levels of potassium and magnesium (from using diuretics, for example) also can cause life-threatening arrhythmias and cardiac arrest.
  • Electrical abnormalities – These, including Wolf-Parkinson-White Syndrome and Long QT Syndrome, may cause sudden cardiac arrest in children and young people.
  • Blood vessel abnormalities – These rare cases occur particularly in the coronary arteries and aorta. Adrenaline released during intense physical activity can trigger sudden cardiac arrest when these abnormalities are present.
  • Recreational drug use – This can occur in otherwise healthy people.

Hypertension Symptoms and Causes (High Blood Pressure)

What is blood pressure?

Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body. Your blood pressure normally rises and falls throughout the day.

What do blood pressure numbers mean?

Blood pressure is measured using two numbers:

The first number, called systolic blood pressure, measures the pressure in your arteries when your heart beats.

The second number, called diastolic blood pressure, measures the pressure in your arteries when your heart rests between beats.

If the measurement reads 120 systolic and 80 diastolic, you would say, “120 over 80,” or write, “120/80 mmHg.

What are normal blood pressure numbers?

A normal blood pressure level is less than 120/80 mmHg.

What is high blood pressure (hypertension)?

High blood pressure, also called hypertension, is blood pressure that is higher than normal. Your blood pressure changes throughout the day based on your activities. Having blood pressure measures consistently above normal may result in a diagnosis of high blood pressure (or hypertension).

The higher your blood pressure levels, the more risk you have for other health problems, such as heart disease, heart attack and stroke. 

Your health care team can diagnose high blood pressure and make treatment decisions by reviewing your systolic and diastolic blood pressure levels and comparing them to levels found in certain guidelines.

The guidelines used to diagnose high blood pressure may differ from health care professional to health care professional:

  • Some health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 140/90 mm Hg or higher.2 This limit is based on a guideline released in 2003, as seen in the table below.
  • Other health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 130/80 mm Hg or higher.1 This limit is based on a guideline released in 2017, as seen in the table below.

The American College of Cardiology/American Heart Association Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (2017 Guideline)

Normalsystolic: less than 120 mm Hg
diastolic: less than 80 mm Hg
Elevatedsystolic: 120–129 mm Hg
diastolic: less than 80 mm Hg

 

If you are diagnosed with high blood pressure, talk with your health care team about your blood pressure levels and how these levels affect your treatment plan.

What are the signs and symptoms of high blood pressure?

High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. Measuring your blood pressure is the only way to know whether you have high blood pressure.

What causes high blood pressure?

High blood pressure usually develops over time. It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Diabetes and being obese, can also increase the risk for developing high blood pressure. High blood pressure also occurs during pregnancy.

What problems does high blood pressure cause?

High blood pressure can damage your health in many ways. It can seriously hurt important organs like your heart, brain, kidneys, and eyes.

The good news is that, in most cases, you can manage your blood pressure to lower your risk for serious health problems.

Heart Attack and Heart Disease

High blood pressure can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease. In addition, decreased blood flow to the heart can cause:

  • Chest pain, also called angina.
  • Heart Attack, which happens when the blood supply to your heart is blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
  • Heart Failure, a condition that means your heart can’t pump enough blood and oxygen to your other organs.

Stroke and Brain Problems

High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a Stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.

Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. 

Kidney Disease

Adults with diabetes, high blood pressure, or both have a higher risk of developing chronic kidney disease than those without these conditions.

How do I know if I have high blood pressure?

There’s only one way to know if you have high blood pressure: Have a doctor or other health professional measure it. It is quick and painless.

High blood pressure is called the “silent killer” because it usually has no warning signs or symptoms, and many people do not know they have it.

What can I do to prevent or manage high blood pressure?

Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about

  • Getting at least 150 minutes of physical activity each week (about 30 minutes a day, 5 days a week)
  • Not smoking
  • Eating a healthy diet, including limiting sodium (salt) and alcohol
  • Keeping a healthy weight
  • Managing stress

In addition to making positive lifestyle changes, some people with

 high blood pressure need to take medicine to manage their blood pressure. 

Talk with your health care team right away if you think you have high blood pressure or if you’ve been told you have high blood pressure but do not have it under control.

By taking action to lower your blood pressure, you can help protect  yourself against heart disease and stroke, also sometimes called cardiovascular disease (CVD).

June is CPR and AED Awareness, National Safety Month, LGBTQ+ and Pride Month

CPR and AED Awareness Week is June 1-7

Only about 48 percent of people who experience an out-of-hospital cardiac arrest receive the immediate help that they need before professional help arrives. 
 
CPR, especially if performed immediately, could double or triple a cardiac arrest victim’s chance of survival. 

Watch the Hands-Only CPR instructional video and share it with the important people in your life.

More June Calendar Highlights

6/1-6/7 – CPR and AED Awareness Week

6/6 – National Cancer Survivors Day

6/14 – Flag Day | World Blood Donor Day | National Call your Doctor Day

6/14-6/21 – Men’s Health Week (6/16 – Check In and Check Up for Your Health with Sybil Wilkes will focus on Men’s Health)

6/17 – National Eat Your Vegetables Day

6/19 – Father’s Day | Juneteenth | World Sickle Cell Day

6/21 – Summer Solstice

6/23 – National Hydration Day | Check In and Check Up for Your Health with Sybil Wilkes will focus on heart health and mental well-being in the LGBTQ+ community

For Safety Reason, You Should Learn CPR.

Cardiac arrest and stroke can happen more often than we think. It happens to anyone at any time, yet most Americans do not know how to perform CPR. When done properly and immediately, CPR has proven to save lives.

The American Heart Association (AHA) has a vast network of instructor’s that train millions of people globally each year with international training centers in more than 100 countries and over 300 translated products. In spite of global efforts and the use of CPR since 1740’s, a high percentage of Americans don’t know how to act or respond during an emergency situation.

Many people say that they do not have time to learn or don’t want to learn CPR.

This mindset may be attributed to the fact that we never fathom the emergency being one of our own.

We do not realize that every single day we are at risk being involved in activities that can lead to an emergency whether work related or driving down the road. A healthy individual may receive an unexpected blow to the chest that causes the heart to stop beating.

A three-year-old toddler may acquire an occluded airway from the thick paste of peanut butter that has stuck to the throat.

What about the little boy who collapsed on the school bus in Atlanta, Georgia on May 7, 2019? Luckily for him he was revived by 7-year-old Janea who recognized an emergency situation had occurred and her immediate actions would help save his life. If you think a young child cannot perform CPR, think again.

During summer, it tends to peak a high rate of water safety incidents.

The Fox 26 News in Houston reported that Texas is number one in the states for drowning incidents.

This is not just a Texas concern, this is every state and every county concern, yet there are several parents and caregivers who have not been trained or a significant amount of time has lapsed since their last CPR training.

Adults and caregivers should refresh their infant, child CPR yearly, especially right before summers when water is involved.

70% of sudden cardiac arrest happens in public places or at home.

Failure to ACT immediately in a cardiac emergency leads to death. When effective bystander CPR is provided an individual’s chance of survival is doubled and even tripled.

Be a keeper for your community, an advocate for your family, and an effective first responder for all who will need you.

Be Trained To act immediately during an emergency situation. Always Remember, EVERY SECOND COUNTS!

New CPR guidance issue by experts addressing the highly contagious Delta and Omicron variants of SARS-CoV-2

In response to the COVID-19 pandemic, the American Heart Association and collaborating organizations, including the American Academy of Pediatrics, the American Association for Respiratory Care, the Society of Critical Care Anesthesiologists and the American Society of Anesthesiologists, continue to provide interim guidance to address the latest scientific research related to the SARS-CoV-2 virus, particularly the Delta and Omicron variants. The updated “2022 Interim Guidance to Health Care Professionals for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19 addresses the emergence of COVID-19 variants that are more transmissible than previous strains.

“Based on evolving epidemiology reports and emerging science, the volunteer committee comprised of more than 40 global resuscitation experts has issued new guidance for the resuscitation of patients with suspected or confirmed COVID-19. This guidance also reflects the recommendations issued recently from both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC).”

Comilla Sasson, M.D., Ph.D., FAHA, practicing emergency medicine physician and vice president for science & innovation for emergency cardiovascular care, American Heart Association

Most significantly, due to new, more highly contagious variants of the SARS-CoV-2 virus, the guidance emphasizes the need for PPE, including respirators, gowns, gloves and eye protection. In the event initial responders are not already wearing appropriate PPE, they should immediately put on PPE and then begin CPR. As the science surrounding COVID-19 and variants evolves, health care professionals should continue to follow the most-up-to-date recommendations from the WHO, CDC and their regional health authorities and local institutions.

“Health care professionals are paramount to the health of communities around the world, especially during a pandemic, and they should be protected while performing health care procedures including resuscitation,” said Dianne Atkins, M.D., FAAP, volunteer chair of the American Heart Association Emergency Cardiovascular Care Committee, a pediatric cardiologist and lead author of the new interim guidance. “Protecting the health and safety of health care professionals remains critical and includes ensuring the recommended personal protective equipment is available and that health care professionals are trained to use it properly.”

Additional updates in the guidance include:

  1. Incorporating the most recent CDC and WHO guidance: All healthcare providers should wear a respirator (e.g., N95) along with other PPE (gown, gloves, and eye protection) for patients with suspected or confirmed COVID-19 infection, when performing aerosol-generating procedures (AGP)s or in a setting where such procedures are regularly performed. This includes wearing appropriate PPE (including a respirator) before performing the components of resuscitation that are aerosol-generating, which include but are not limited to chest compressions, defibrillation, bag-mask ventilation, intubation or positive-pressure ventilation.

2. Reinforcing resuscitation best practices: Cardiac arrest survival rates have decreased dramatically during the COVID-19 pandemic. Out of hospital cardiac arrest survival in 2020 also declined in regions/timeframes that did and did not have significant COVID infection rates. The reasons for this decline are both unclear and complex. Cardiac arrest survival is dependent on early initiation of CPR, including chest compressions as soon as it is safely possible. Patients with confirmed or suspected COVID-19 should receive the best resuscitative efforts possible.

3. Ensuring adequate PPE supply: At this time, all healthcare providers should be following appropriate precautions and should have access to PPE in all clinical settings, regardless of the potential of encountering resuscitation events. Effective use of PPE is critical for the safety of healthcare providers performing resuscitations. Healthcare organizations should continue to secure appropriate PPE as available, ensure training regarding appropriate application and use of PPE, reinforce effective use of PPE, and create systems so that health care providers have immediate access to appropriate PPE when emergency care is required.

As the COVID-19 pandemic persists and new variants arise, the American Heart Association with its collaborating professional organizations will continue to provide the most up-to-date, evidence-based guidance on resuscitation and supporting the health care professionals that provide these life-saving procedures such as CPR.

American Heart Association guidance articles promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements and guidance documents outline what is currently known about a topic and what areas need additional research. While scientific statements and guidance documents inform the development of formal guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Wearing PPE During CPR continues to be required

The UI Health Care’s top priority is Safety. Recently, the American Heart Association (AHA) released new guidance recommending that chest compressions or defibrillation should not be delayed for retrieval and application of a mask or face covering, for either the patient or provider.

This new guidance stems from recent observations that survival outcomes following cardiac arrest have worsened during the pandemic. This decline in survival has been attributed to multiple factors, including delays in initiating CPR due to donning personal protective equipment (PPE), and rescuer fatigue during CPR from PPE.

UI Health Care employees are required to wear a medical-grade mask at all times while in our facilities, unless they’re alone in a private office or when eating/drinking.

We believe the new guidance from the AHA has the potential to expose health care workers. Therefore, UI Health Care will maintain its current guidance that standard precautions with universal masking be followed during all patient care, with the addition of respiratory protection (N95s) during CPR.

Our decision was made after discussion with many of our experts and serves as the latest example of UI Health Care’s commitment to maintaining a safe environment for all patients, visitors, and staff.

7
Dec, 2021
Food Safety Tips During Holiday Season

Food and Drinks Safety Tips During Holiday Season

Prevent Food Poisoning During the Holidays

Feasting with family is part of many holiday celebrations. Follow these tips to help prevent food poisoning, or foodborne illness, during the holidays.

  • Keep foods separated. Keep meat, chicken, turkey, seafood, and eggs separate from all other foods at the grocery store and in the refrigerator. Prevent juices from meat, chicken, turkey, and seafood from dripping or leaking onto other foods by keeping them in containers or sealed plastic bags. Store eggs in their original carton in the main compartment of the refrigerator.
  • Cook food thoroughly. Meat, chicken, turkey, seafood, and eggs can carry germs that cause food poisoning. Use a food thermometer to ensure these foods have been cooked to a safe internal temperature. Roasts, chops, steaks, and fresh ham should rest for 3 minutes after you remove them from the oven or grill.
  • Keep food out of the “danger zone.” Bacteria can grow rapidly in the danger zone between 40°F and 140°F. After food is prepared, keep hot food hot and cold food cold. Refrigerate or freeze any perishable food within 2 hours (1 hour if food is exposed to temperatures above 90°F, such as in a hot car). The temperature in your refrigerator should be set at or below 40°F and the freezer at or below 0°F.
  • Use pasteurized eggs for dishes containing raw eggs. Salmonella and other harmful germs can live on both the outside and inside of normal-looking eggs. Many holiday favorites contain raw eggs, including eggnog, tiramisu, hollandaise sauce, and Caesar dressing. Always use pasteurized eggs when making these and other foods made with raw eggs.
  • Do not eat raw dough or batter. Dough and batter made with flour or eggs can contain harmful germs, such as E. coli and Salmonella. Do not taste or eat raw dough or batter that is meant to be baked or cooked. This includes dough or batter for cookies, cakes, pies, biscuits, pancakes, tortillas, pizza, or crafts. Do not let children taste raw dough or batter or play with dough at home or in restaurants. Some companies and stores offer edible cookie dough that uses heat-treated flour and pasteurized eggs or no eggs. Read the label carefully to make sure the dough is meant to be eaten without baking or cooking.
  • Thaw your turkey safely. Thaw turkey in the refrigerator, in a sink of cold water (change the water every 30 minutes), or in the microwave. Avoid thawing foods on the counter. A turkey must thaw at a safe temperature to prevent harmful germs from growing rapidly.
  • Wash your hands. Wash your hands with soap and water during these key times when you are likely to get and spread germs:
    • Before, during, and after preparing food
    • Before eating food
    • After handling pet food or pet treats or touching pets
    • After using the toilet
    • After changing diapers or cleaning up a child who has used the toilet
    • After touching garbage
    • Before and after caring for someone who is sick
    • Before and after treating a cut or wound
    • After blowing your nose, coughing, or sneezing

Holiday Food and Beverages for Pregnant

Pregnant women are at increased risk of food poisoning, so take extra care if you’re pregnant or preparing food for someone who is.

  • Do not eat or drink raw or unpasteurized milk and products made with it, such as soft cheeses. They can contain harmful germs, including Listeria. Do not eat soft cheeses such as queso fresco Brie, Camembert, feta, goat cheese, or blue-veined cheese if they are made from raw or unpasteurized milk.
    • Be aware that cheeses made from pasteurized milk, such as queso fresco, also have caused Listeria infections, most likely because they were contaminated during cheese-making.
    • Processed cheeses, cream cheese, mozzarella, and hard cheeses are safer choices.
    • Don’t drink raw or unpasteurized juice and ciderexternal icon.
    • Be careful with seafoodexternal icon. Do not eat smoked seafood that was sold refrigerated unless it is in a cooked dish, such as a casserole. Instead, choose shelf-stable smoked seafood in pouches or cans that do not need refrigeration.
    • Avoid certain holiday beverages. Drinking any type of alcohol can affect your baby’s growth and development and cause fetal alcohol spectrum disorders. Don’t drink holiday punches and eggnogs that contain alcohol. Avoid eggnog entirely unless you know it doesn’t contain alcohol and is pasteurized or made with pasteurized eggs and milk.

The Myths about CPR and are They True?

The Myth about CPR

CPR is short for cardiopulmonary resuscitation. It is an emergency procedure in which rescue breathing and chest compressions are combined. For example, it can save a life of a person who stopped breathing or whose heart stopped beating. 

The procedure itself is not simple, but still, the fact is that with proper training, children as young as nine can learn it and apply it. And statistics show that providing CPR to a victim before professional medical help arrives significantly increases the chances of survival. 

So why isn’t this skill familiar to more people? Maybe the myths around CPR are to blame. In the following lines, we examine the greatest among them and if there is any truth behind them. 

If you do CPR in the wrong way you can make the situation worse

Witnessing a person in a life-threatening situation is never easy, whether they are strangers or not. Many people, especially if they are just bystanders, will think: “I do not want to get involved because I might hurt this person even more.” 

However, what you should keep in mind is that when a heart or breath stops, vital organs start dying very quickly. And it pretty much does not get any worse than death. So, you should try to help. Make sure you call the ambulance immediately because the dispatcher will help you with the procedure, too. 

Only professionals can do CPR right 

Most people have only seen CPR in movies and on TV. And there, those providing it are usually policemen, agents, firefighters, lifeguards, EMTs, nurses, and other everyday superheroes. So it makes sense then that it is commonly believed this procedure can only be done by trained professionals. 

But, as we already mentioned, while not simple, the procedure is simple enough to be taught to children above the age of nine. In addition, the courses do not take much of your time.

Having done this sort of training also busts the previous myths because it gives you the confidence to do it right and helps you gain control of an emergency. All this increases the chances of survival for the victim, which is the ultimate goal. 

There is no CPR without mouth-to-mouth

Another myth about CPR we probably owe to the movies and TV is the belief that CPR cannot be done without mouth-to-mouth. With this in mind, many people will give up on learning it or applying it, even if it is for their loved ones. 

But in reality, a procedure called Hands-only CPR is much more common. It includes chest compressions, and statistics show that, when done correctly, they are enough. Rescue breaths, commonly known as mouth-to-mouth, should be done by professionals using an appropriate mask. 

My loved ones are healthy so I will never need to use my CPR training

Most people seem to think that causes for a heart to stop or the inability to breathe are solemnly connected to serious diseases. The truth is, however, that it can be accidents that cause them, like drowning or electrocution. 

We can never know when a friend or a family member can fall victim to a life-threatening accident. And unfortunately, someone’s health can get worse suddenly, so in reality, you never know when you might need to use CPR. 

Another thing statistics suggest is that the person in need of CPR is more often some we care about, rather than someone on the street we never met before. So, we can think we will not need it, but reality proves otherwise. 

CPR is only about saving a life 

Cardiopulmonary resuscitation is necessary to save a life and we will not argue with this fact. But, most people have the misconception that that is all there is to it. 

The fact is, however, that during a cardiac arrest, not enough oxygen arrives in the brain. This causes brain cell death, whose consequence is irreversible neurological damage. By applying CPR, the rescuers make sure oxygen is supplied to the brain, minimizing the risk of damage.

In a nutshell 

To put it simply, one more time, CPR can save lives. This is why it is important to educate people about it, to make them understand how crucial it can be, and work our a way to eventually make it a part of every school’s curriculum. Only proper education can stop people from spreading and believing in myths. 

First Support CPR and First Aid Training offers CPR classes in San Jose. For inquiries you can email us at info@firstsupportcpr.com or call us at 408-475-7724

 

AHA Updates CPR Guidelines for Patients With COVID-19

An updated American Heart Association (AHA) guidance on cardiopulmonary resuscitation (CPR) for patients with suspected or confirmed COVID-19 states that the risk of death to the patient from withholding or delaying treatment for cardiac arrest is extremely high, while the risk of infection and serious disease for the provider is comparably much lower, particularly in providers receiving recommended COVID-19 vaccine doses and wearing appropriate personal protective equipment (PPE).

“The guidelines appropriately evolved as we learned more about COVID-19 and its spread,” commented Lamont Hunter, MPH, PA-C, president of the Society of Emergency Medicine Physician Assistants (SEMPA) and director of Emergency Medicine Advanced Practice Providers at Cottage Health, Santa Barbara, CA. “These guidelines are useful for PAs and [nurse practitioners] working in emergency medicine and EMS and should serve as a reminder that high-quality CPR should not be delayed for those with suspected or confirmed COVID-19,” said Mr Hunter, who was not involved in the development of the AHA guidance.

AHA Updates CPR Guidelines

The AHA guidance and collaborating organizations released their first interim guidance for the resuscitation of patients with suspected or confirmed COVID-19 in April 2020. This guidance was updated based on updated AHA CPR guidelines released in October 2020, increased understanding of SARS-CoV-2 transmissibility, more stable access to PPE, and COVID-19 vaccination.

In the latest guidelines, the AHA introduces updated COVID-19 resuscitation algorithms based on the 2020 AHA Guidelines for CPR and emergency cardiovascular care and includes a COVID-19 maternal cardiac arrest algorithm. There is a new emphasis on providing chest compressions and defibrillation without delay, and added insight about potential aerosol-generating procedures (AGPs) and when specific PPE should be used (Table).

Highlights of 2021 Interim Guidelines on Cardiac Life Support in Patients with COVID-19

Survival outcomes for cardiac arrests have worsened since the start of the COVID-19 pandemic
Quality care for cardiac arrests requires rapid initiation of chest compressions. This likely carries a low risk of SARS-CoV-2 transmission to the compressor.
For witnessed sudden cardiac arrests, chests compressions should be initiated immediately. Providers should not delay chest compressions to put on PPE or place face covering on patients. For pediatric patients, ventilations should be prioritized.
Providers wearing appropriate PPE should replace providers without sufficient PPE. For aerosol-generating procedures, appropriate PPE includes N95 masks with eye protection or positive-airway pressure respirators, gloves, and gowns.
For agonal breathing, consider passive oxygenation overlaid with a surgical face mask (if available) until a bag-mask device or HEPA-filtered device can be applied
Defibrillation should be performed as soon as indicated, and should not be delayed to put on masks or other PPE
HEPA filters should be securely attached along the exhalation ports of any ventilation devices. Low-dead space viral filters or heat and moisture exchanging filters with >99.99% viral filtration efficiency can be installed between the ventilation device and the airway as an alternative.
Video laryngoscopy and mechanical compression devices may be considered in institutions where they are available and personnel are already trained
Advanced care directives and goals of care should be discussed with all patients with suspected or confirmed COVID-19 when they arrive at the hospital and following any significant changes in clinical status. Health care providers should commit to ethical and evidence-based organizational policies when making decisions related to initiating and continuing resuscitation.
Newborn babies are unlikely to spread COVID-19, regardless of their mothers’ COVID-19 status; however, maternal respiratory secretions have the potential to transmit SARS-CoV-2