Pandemic BLS Video
Our suggested changes to BLS to keep you safe and the area around the patient free of COVID-19 (a mixture of evidence, pragmatism and opinion):
- In a pandemic use a modified form of the usual D.R.S. A.B.C. approach
- Rationale = CPR can be risky in the context of COVID-19 (opinion) – droplets and aerosols (see video)
- Approach the patient checking for usual danger, check for response (with caution)
- If no response leave the patient to send for help
- Donning of P.P.E. (Gloves, Gown, N95 mask, eye protection, head covering) = 5-point
- Then return to patient to complete ABC with the addition of patient coverings
- This can delay CPR by around 90 seconds (the time taken to don PPE safely and return to patient)
- In a hospital context, this may feel like slower the usual standard of starting CPR…
- However, in the community delays and poor quality CPR would be likely, pandemic precautions should not delay defibrillation and staff safety should take precedence in a pandemic scenario.
- If the patient is monitored and in VF or VT – then shock (consider 3-stacked shocks) – this should be safe relative to CPR
- Protect staff with PPE, protect environmental contamination with barriers (we suggest a surgical mask, oxygen mask and plastic sheet)
- Given the confronting nature of the delay in CPR, plastic sheet and resulting stress ensure staff wellbeing.
- Some programs to consider might include optional formal ‘debriefing’, instructions on access to psychological services and small support group allocations within the ED healthcare team