References
Chest Compressions and Defibrillation as Aerosolgenerating Procedures
Abstract
SARS-CoV-2 is a highly contagious respiratory pathogen associated with significant mortality in certain patient populations. Patients may be asymptomatic, which causes problems regarding infection control and prevention. Health professionals are required to adhere to strict protocols regarding infection control and personal protective equipment (PPE), particularly when engaging in resuscitation activities thought to be aerosol-generating procedures (AGPs). While adherence to enhanced PPE protocols can delay life-saving interventions, non-adherence may put responders at risk. The aim of this scoping literature review was to establish if chest compressions and defibrillation should be classified as AGPs. Following application of systematic literature search criteria, a limited selection of studies was identified in relation to chest compressions and defibrillation as AGPs. An assumption that endotracheal intubation posed a high risk of nosocomial transmission was noted. Emerging evidence suggests that endotracheal intubation produces fewer aerosol particles than coughing so could be classed as a low-risk-procedure. Because of the lack of adequate prospective studies investigating chest compressions and defibrillation as AGPs, there is a clear need to perform further, well-controlled studies to better understand the aerosol-generating potential of chest compressions and defibrillation.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belongs to a family of highly contagious respiratory coronaviruses and is associated with high levels of mortality in certain patient populations (Chandrasekharan et al, 2020; Cheruku et al, 2020). Disease presentation, in the form of COVID-19, typically involves cough, pyrexia and dyspnoea; however, symptomology may be highly variable, with asymptomatic patients creating problems regarding infection control and prevention (Atzrodt et al, 2020; Fink et al, 2020). A pandemic was declared by the World Health Organization (WHO) in March 2020 and the resulting global disruption remains ongoing (Kalita et al, 2022). As of 7 July 2022, COVID-19 has been responsible for over 6.8 million deaths worldwide (WHO, 2023).
It is postulated that COVID-19’s route of transmission is through respiratory droplets, bioaerosols and fomites (Fink et al, 2020). As a result, health professionals are required to adhere to strict protocols regarding infection control and personal protective equipment (PPE), particularly when in proximity to medical activities thought to be aerosol-generating procedures (AGPs) (Leong et al, 2020). During the early stages of the pandemic, advice issued regarding appropriate levels of PPE was inconsistent (Hoernke et al, 2021).
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed