Expert consensus on prevention and cardiopulmonary resuscitation for cardiac arrest in COVID-19

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Treatment of 60 anaphylactic shock patients with Shenmai injection / 第三军医大学学报

Objective To assess the clinical efficacy of Shenmai injection for the treatment of anaphylactic shock patients and to observe the changes of microcirculation, blood pressure, and volume of urine. Methods Sixty cases of anaphylactic shock were treated with Shenmai injection plus Western medicine (treatment group) and 36 cases of anaphylactic shock treated with Western medicine only(control group). Hemorheological changes, consciousness, temperature, pulse and NSPO 2 were compared. Results The blood pressure recoverable rate of anaphylactic shock in the treatment group was significantly higher than that in the control group. The blood pressure recoverable rates at 4 h after the therapy were 68.3% and 22.2% in the treatment group and the control group, respectively. The average urine volume of treatment group at 2, 3, 4, 5 and 6 h after the therapy was significantly higher than that of the control group ( P