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CODE BLUE-19: Proposal to Mitigate COVID-19 Transmission in the Emergency Department for Out-of-hospital Cardiac

David Nguyen1, Nima Sarani1, Kenneth D Marshall1

  • 1Kansas University Medical Center, Department of Emergency Medicine, Kansas City, Kansas.

The Western Journal of Emergency Medicine
|November 18, 2020
PubMed

Insights

Healthcare workers face increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure during cardiac arrest resuscitation in coronavirus disease 2019 (COVID-19) patients. A protocolized approach for out-of-hospital cardiac arrests is proposed to mitigate transmission risks.

Area of Science:

  • Emergency Medicine
  • Infectious Diseases
  • Cardiology

Background:

  • Resuscitation efforts for cardiac arrest in patients with coronavirus disease 2019 (COVID-19) pose significant exposure risks to healthcare staff via severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
  • The unknown COVID-19 status of many emergency department (ED) patients necessitates stringent protective measures for staff and other patients.
  • Out-of-hospital cardiac arrest (OHCA) patients transported to the ED present a heightened transmission risk scenario.

Purpose of the Study:

  • To propose a protocolized approach for managing out-of-hospital cardiac arrests (OHCA) in the context of the COVID-19 pandemic.
  • To outline strategies for minimizing SARS-CoV-2 transmission risk to healthcare professionals and other patients during resuscitation.
  • To provide guidance based on current data regarding SARS-CoV-2 transmissibility.

Main Methods:

  • Review of current data on SARS-CoV-2 transmissibility.
  • Development of a protocol for the management of OHCA patients presenting to the ED.
  • Emphasis on protective measures for healthcare staff during resuscitation.

Main Results:

  • A protocolized approach for OHCA resuscitation in the COVID-19 era has been developed.
  • The protocol aims to balance effective resuscitation with the critical need for infection control.
  • Recommendations are based on the understanding of SARS-CoV-2 transmission dynamics.

Conclusions:

  • Implementing a protocol for OHCA resuscitation is crucial for protecting healthcare workers from SARS-CoV-2 exposure.
  • Proactive measures are essential when managing patients with unknown COVID-19 status in the ED.
  • The proposed protocol addresses the unique challenges posed by COVID-19 in emergency cardiac care.

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