It is an action that can be life-saving in most cases: resuscitation. By correctly applying mouth-to-mouth resuscitation and chest compressions, a person with heart failure can be helped quickly. But… what about the current coronavirus? How can emergency workers perform resuscitation responsibly?
An adapted resuscitation protocol
The fear of infection with the COVID-19 virus is currently great. However, by means of an adjusted protocol, drawn up by, among others, the Dutch Resuscitation Council, the RIVM and the Ministry of Health, Welfare and Sport, resuscitation can still be successfully performed. Mouth-to-mouth resuscitation is more difficult in the current time of Corona.
The control room of the national 112 emergency number has an adjusted resuscitation policy during the corona virus. With this, the operator assesses whether the victim of the cardiac arrest is infected with the COVID-19 virus. If the operator receives information that probably indicates an infection, the operator asks to pass this on to the emergency services on site.
What is the modified protocol for resuscitation?
If you want to help someone who is infected with the COVID-19 virus, assess breathing by looking only. At the moment of cardiac arrest, the blood is usually still sufficiently supplied with oxygen for the first few minutes. It is then important that this oxygen is pumped around the body. And that is what chest compressions during resuscitation are needed for. An AED may also be connected. In short, when it is known that a person is infected with the coronavirus:
> Check the breathing
> Do not give mouth-to-mouth resuscitation
> Do give chest compressions
> Do connect an AED.
Do respiratory masks also protect against the coronavirus?
The special resuscitation masks serve as a hygienic aid during resuscitation and prevent the transmission of certain pathogens via mucus, blood and breath. Such a resuscitation mask is placed over the mouth of the victim, thus avoiding direct contact. However, these masks do not protect or do not sufficiently protect against the virus!
Step-by-step plan
The Dutch Heart Foundation has created a step-by-step plan regarding the resuscitation of a person without an AED, see below. This step-by-step plan applies again, unless the dispatcher assesses that information indicates that the victim is infected with COVID-19.
Step 1. Is the environment safe? Then check the awareness
- Shake shoulders and ask how things are going
- No response? This means the victim is unconscious
Step 2. Call 112
- Call for an ambulance and indicate that the person is unresponsive
- Put the phone on speakerphone, the emergency responder on the phone will guide you through the resuscitation
- Ask bystanders to get an AED. Are you alone? Only get the AED if it is within reach.
Step 3. Check breathing
- Place one hand on the forehead and gently tilt the head back, opening the airway
- Using two fingertips of the other hand, lift the chin (chin lift)
- Look, listen and feel for a maximum of 10 seconds to see if there is breathing
- No breathing? Start CPR
Step 4. Chest compressions
- Interlock your hands and place them in the middle of your chest
- Straighten your elbows and bring your shoulders directly above your hands
- Depress the sternum 5 to 6 centimeters
- Give 30 chest compressions, 100 to 120 times per minute
Step 5. Give two breaths
- Clear the airway (tilt head and lift chin) and pinch the nose closed.
- Inhale normally, place your lips around the victim’s mouth. Exhale evenly into the victim’s mouth for one second. Look out of the corner of your eye to see if the victim’s chest rises
- Repeat this so that you give a total of two breaths within 10 seconds
Step 6. Continue CPR
- Continue alternating between 30 chest compressions and two breaths
- Continue until the AED arrives
- Do not stop when the ambulance arrives, wait until they take over
In addition, a step-by-step plan is also available regarding resuscitation using an AED , see below:
Step 1. Follow the AED instructions
- Expose chest and interrupt chest compressions for as short a time as possible
- Activate the AED
- If someone else is present, have them turn on and connect the AED so that you can move on to chest compressions and rescue breathing
- Attach the electrodes to the bare chest
- Listen and do what the AED says
- Make sure that no one touches the victim while the AED is analyzing the heart rhythm
- AED can then either execute a shock command or not
Step 2. AED gives shock command
- Ask everyone to keep their distance from the victim when the AED is performing a shock command
- Immediately after the shock command, start again with 30 chest compressions
Step 3. AED does not give shock command
- Continue with the 30 chest compressions
Step 4. Victim comes to
- If the victim opens his/her eyes and starts breathing normally, check the breathing. If the breathing is normal, place the victim in the stable side position. You may leave the electrodes of the AED on the victim
Resuscitation tools save lives!
The normal resuscitation protocol is now in force nationwide again. Are you responsible for the emergency response within your organization? And do you want to add resuscitation aids to your emergency response plan? Then take a look at our wide range of resuscitation aids and feel free to contact us if you have any questions. For more information about resuscitation during the coronavirus, we advise you to contact the Infolijn of the Dutch Heart Foundation.