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During SARS, healthcare workers made up approximately 20% of worldwide infections (Chan-Yeung, 2004). Media reports suggest that over 60 Italian doctors have died from COVID-19 (CNN, 2020).

The capacity of healthcare systems across Australia and New Zealand are expected to be challenged by the COVID-19 pandemic. If a healthcare worker contracts COVID-19, not only does their illness have personal consequences, which may be severe, it also increases the burden on the healthcare system, and reduces the capacity of the system to deal with future patients.

We recommend:

  1. During the period in which there is a COVID-19 epidemic in the country and high rates of community transmission, unless there is clear evidence to the contrary, any collapsed / unresponsive patient should be assumed to be high-risk for COVID-19.
  2. Health care workers should only perform resuscitative interventions when they are protected by appropriate personal protective equipment (PPE).
  3. Health care workers must not perform resuscitative interventions if they are not adequately protected by appropriate PPE.

Therefore, modifications to the traditional approach to cardiac arrest are needed.

We align with published guidelines and statements from:

  1. New Zealand Resuscitation Council (NZRC, 2020).
  2. Resuscitation Council UK (RCUK, 2020).
  3. Australian Resuscitation Council (ARC, 2020).
  4. American Heart Association (AHA, 2020).
  5. International Liaison Committee on Resuscitation (ILCOR, 2020).

As the COVID-19 pandemic has progressed, there is some emerging evidence to guide this document. However, with an overall aim to ensure a safe working environment for healthcare workers, we have been deliberately conservative with many recommendations.

  • Is resuscitation appropriate?
  • Summary of minimum personal protective equipment (PPE) for various resuscitation procedures
  • Optimal setting for resuscitation
  • Staff safety and prevention of occupational exposure to COVID-19
  • Modifications to cardiac arrest management in the COVID-19 era
  • Post-resuscitation care
  • Example algorithm
  • References
  • Section disclaimer