Taha Hesham S, Shaker Mirna M, Abdelghany Mohamed M
Department of Cardiology, Faculty of Medicine, Cairo University, 27 Nafezet Sheem El Shafae St Kasr Al Ainy, Cairo, 11562, Egypt.
Egypt Heart J. 2020 Oct 27;72(1):73. doi: 10.1186/s43044-020-00106-9.
The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges.
This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient's back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken.
Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.
新冠疫情给埃及的医疗系统带来了巨大负担，面对这种可能致命的高传染性疾病，医疗系统需要改变其管理方案以应对这些新挑战。
这份由开罗大学心脏病学系制定的科学声明强调了6个不同方面，旨在指导医疗服务提供者在新冠疫情时代进行心肺复苏（CPR）。它强调了在疫情期间将所有心脏骤停患者视为潜在新冠病例进行处理的重要性，以及医疗服务提供者在操作过程中使用适当个人防护装备（PPE）的重要性。它还指出，心肺复苏操作应在一个单独的、门关闭的房间内进行，操作过程中在场的人员数量应仅限于对患者复苏至关重要的人员。它还强调，可能感染新冠的患者的家属和陪同人员不应在心肺复苏现场附近。该声明还指出，心肺复苏操作应以标准方式进行，并采取预防措施以尽量减少感染传播给工作人员和陪同人员。优先进行早期插管，并建议在使用适当个人防护装备的情况下采用快速顺序插管。对于俯卧通气患者进行心肺复苏时，建议在一组人员准备将患者翻转为仰卧位时，通过按压患者背部进行胸外按压。在院内转运期间，强调应通知接收重症监护病房（ICU）患者可能新冠检测呈阳性的情况，以便采取适当的感染控制预防措施。
在新冠疫情时代，对心脏骤停患者进行心肺复苏构成了重大挑战，所有医疗服务提供者应将出现在急诊科的任何心脏骤停患者视为潜在的新冠疑似病例进行处理，并应使用适当的个人防护装备。
