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Should chest compressions be considered an aerosol-generating procedure? A literature review in response to recent guidelines on personal protective equipment for patients with suspected COVID-19.
Brown, Evelyn; Chan, Lai Man.
  • Brown E; Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
  • Chan LM; Royal Victoria Infirmary, Newcastle-upon-Tyne, UK lai.chan@nhs.net.
Clin Med (Lond) ; 20(5): e154-e159, 2020 09.
Article in English | MEDLINE | ID: covidwho-1360886
ABSTRACT
There is disagreement between international guidelines on the level of personal protective equipment (PPE) required for chest compressions for patients with suspected COVID-19. This discrepancy centres on whether they are considered to be an aerosol-generating procedure (AGP), thus requiring airborne protection to prevent transmission to healthcare workers (HCWs). The need to don higher-level PPE has to be weighed against the resulting delay to emergency treatment.We performed a literature search on this topic which found eight relevant studies. All were observational with low patient numbers and multiple confounding factors, but describe cases of acute respiratory infection transmission during chest compressions. One systematic review concluded that chest compressions were not an AGP. Two simulated studies (released as preprints) potentially demonstrate aerosol generation. Given that there is evidence for infection transmission during chest compressions, we conclude that a precautionary approach with appropriate PPE is necessary to protect HCW from contracting a potentially fatal infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cross Infection / Cardiopulmonary Resuscitation / Practice Guidelines as Topic / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Pandemics / Personal Protective Equipment Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Clin Med (Lond) Year: 2020 Document Type: Article Affiliation country: Clinmed.2020-0258

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Cross Infection / Cardiopulmonary Resuscitation / Practice Guidelines as Topic / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Pandemics / Personal Protective Equipment Type of study: Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Clin Med (Lond) Year: 2020 Document Type: Article Affiliation country: Clinmed.2020-0258