Thread by @PulmCrit

Cardiac arrest during the COVID pandemic. Yikes.
- @FTeranMD at #HRreloaded

data from Italy:
- increased incidence of arrest during COVID surges (greatest in provinces with highest COVID rate)
- more unwitnessed arrests, higher field mortality, lower rate of bystander CPR
- @FTeranMD at #HRreloaded

data from Paris:
- higher rate of arrest during COVID pandemic
- more arrests at home, lower bystander CPR, longer delays to intervention, fewer people alive at hospitalization
- @FTeranMD at #HRreloaded

do bystanders place themselves at risk by doing CPR?
- first link in the chain of survival = bystander CPR
- when you do the math, hands-only CPR should save lives
- @FTeranMD at #HRreloaded

AHA & ILCOR guidelines based on "best available evidence." unfortunately this is mostly expert-level opinion
- @FTeranMD at #HRreloaded

why more arrests?
- COVID causes vascular inflammation & myocarditis?
- excess Netflix?
- In France, most increase wasn't directly due to COVID. So arrests may be due largely to non-COVID patients delaying hospital admission in response to chest pain
- @FTeranMD at #HRreloaded

practical tips to improve codes in COVID:
- have a plan (donning PPE? when to call code?)
- define who is in room & how to *communicate* to support staff outside the room
- @FTeranMD at #HRreloaded

4-hand CPR technique:
- Two-hand mask seal reduces aerosolization (and it's preferred practice anyways to optimize mask seal)
- @FTeranMD at #HRreloaded