Kulkarni Atul P, Singh Yudhyavir, Garg Heena, Jha Simant
Division of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Parel (E), Mumbai, Maharashtra, India.
Department of Anesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Crit Care Med. 2020 Sep;24(9):868-872. doi: 10.5005/jp-journals-10071-23544.
The crisis caused by Coronavirus disease-2019 (COVID-19) pandemic has led us to safeguard ourselves and our colleagues against transmission of this highly contagious infection, while aiming for the same goals of care. In spite of the stringent measures adopted by affected countries, rising number of healthcare workers (HCWs) are getting infected, dwindling the scarce manpower at our disposal. In the pre-COVID-19 times, cardiopulmonary resuscitation (CPR) was offered unhesitantly to all patients, who had even a slim chance of achieving return of spontaneous circulation. In COVID-19 era, CPR, due to some components being high aerosol-generating procedures (AGPs), has become high-risk procedure for the HCWs. Instead of "" (first do no harm), we are forced to change to "" (first do no harm to yourself). The challenge is therefore to provide best possible chance of survival to deserving patients, whose COVID-19 status might be unknown, without causing harm to the HCWs. In this review, we discuss the current data regarding infected HCWs, outcomes of inhospital and out-of-hospital cardiac arrests, components of CPR which are high-risk AGPs, how to safeguard the HCWs while offering CPR, and the ethical considerations when CPR is considered, in this COVID-19 era. We wish to emphasize here that there is NO EMERGENCY in a pandemic, and time must be made for donning appropriate PPE. We feel that clear policies need to be developed by the institutions to deliver CPR to correct population, in this challenging period. Kulkarni AP, Singh Y, Garg H, Jha S. Cardiopulmonary Resuscitation during COVID-19 Pandemic: Outcomes, Risks, and Protective Strategies for the Healthcare Workers and Ethical Considerations. Indian J Crit Care Med 2020;24(9):868-872.
2019年冠状病毒病（COVID-19）大流行引发的危机，促使我们在努力实现相同护理目标的同时，保护自己和同事免受这种高传染性感染的传播。尽管受影响国家采取了严格措施，但感染的医护人员数量仍在增加，导致我们可用的稀缺人力不断减少。在COVID-19之前的时代，对于所有哪怕只有极小机会实现自主循环恢复的患者，都会毫不犹豫地进行心肺复苏（CPR）。在COVID-19时代，由于CPR的某些环节属于高气溶胶产生操作（AGP），它已成为医护人员的高风险操作。我们被迫从“不伤害（患者）”转变为“不伤害自己”。因此，挑战在于为那些COVID-19感染状况可能未知但值得救治的患者提供最佳生存机会，同时又不伤害医护人员。在本综述中，我们讨论了关于感染医护人员的当前数据、院内和院外心脏骤停的结果、作为高风险AGP的CPR环节、在进行CPR时如何保护医护人员，以及在这个COVID-19时代考虑CPR时的伦理考量。我们在此强调，在大流行期间不存在紧急情况，必须有时间穿戴合适的个人防护装备。我们认为，在这个具有挑战性的时期，各机构需要制定明确的政策，以便为合适的人群实施CPR。 库尔卡尼AP、辛格Y、加尔格H、贾S。COVID-19大流行期间的心肺复苏：医护人员的结果、风险、保护策略及伦理考量。《印度危重症医学杂志》2020年；24(9):868 - 872。
