Leong Yuen Chin, Cheskes Sheldon, Drennan Ian R, Buick Jason E, Latchmansingh Ron G, Verbeek P Richard
Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Resusc Plus. 2020 Dec;4:100027. doi: 10.1016/j.resplu.2020.100027. Epub 2020 Sep 14.
Managing out-of-hospital cardiac arrest requires paramedics to perform multiple aerosol generating medical procedures in an uncontrolled setting. This increases the risk of cross infection during the COVID-19 pandemic. Modifications to conventional protocols are required to balance paramedic safety with optimal patient care and potential stresses on the capacity of critical care resources. Despite this, little specific advice has been published to guide paramedic practice. In this commentary, we highlight challenges and controversies regarding critical decision making around initiation of resuscitation, airway management, mechanical chest compression, and termination of resuscitation. We also discuss suggested triggers for implementation and revocation of recommended protocol changes and present an accompanying paramedic-specific algorithm.
管理院外心脏骤停需要护理人员在不受控制的环境中执行多种产生气溶胶的医疗程序。在新冠疫情期间，这增加了交叉感染的风险。需要对传统方案进行修改，以平衡护理人员的安全、最佳的患者护理以及重症监护资源能力方面的潜在压力。尽管如此，几乎没有发布具体建议来指导护理人员的实践。在这篇评论中，我们强调了在复苏启动、气道管理、机械胸外按压和复苏终止等关键决策方面的挑战和争议。我们还讨论了建议的实施和撤销推荐方案变更的触发因素，并给出了一个针对护理人员的配套算法。
