Should you be performing CPR differently during the coronavirus pandemic?

'Do not put your face close to theirs,' British Heart Foundation states

If a person has collapsed and does not appear to be breathing normally or at all, then CPR (cardiopulmonary resuscitation) could help save their life before emergency healthcare professionals arrive at the scene.

CPR typically involves checking their airways, doing chest compressions and delivering rescue breaths through mouth-to-mouth.

However, in light of the coronavirus pandemic, carrying out the standard stages of CPR could increase risk of infection spreading.

Therefore, several organisations have issued updated guidelines on how to perform CPR​ in the current climate.

What advice has changed?

The Health and Safety Executive (HSE) in Ireland states that if a person has collapsed in a public place, you should check for signs of life and that they are breathing. However, you should not check if they’re breathing by placing your ear or cheek close to their mouth.

When you call 112 or 999 and ask for an ambulance, you should tell the person on the phone if you think the unconscious individual could have Covid-19.

The HSE states that you must make sure that you keep your hands away from your face at all times and if you are performing CPR, you should only perform chest compressions, foregoing mouth to mouth rescue breaths.

“If there is a perceived risk of infection, you should place a cloth/towel over the person’s mouth and nose and attempt compression only CPR and early defibrillation until help arrives,” the agency says.

The HSE advises using an AED (automated external defibrillator) as soon as possible, a procedure that should be carried out by a first responder.

After performing CPR, you should clean your hands thoroughly either with soap and water or an alcohol-based hand sanitiser.

Is the advice the same across the UK?

The British Heart Foundation published advice provided by the Resuscitation Council UK on the changes to CPR during the pandemic.

This advice consists of five steps when taking care of an unconscious person: shake and shout for help; call 999; do not put your face close to theirs, and use a towel or a piece of clothing to cover their mouth and nose; deliver chest compressions; and continue until an ambulance arrives.

When giving chest compressions, the Resuscitation Council UK advises first kneeling next to the unconscious individual.

Then, you need to place the heel of one hand in the centre of the person’s chest, before placing your other hand on top and interlocking your fingers.

“With straight arms, use the heel of your hand to push the breastbone down firmly and smoothly, so that the chest is pressed down between 5–6 cm, and release,” the organisation states.

“Do this at a rate of 100 to 120 chest compressions per minute – that’s around 2 per second.”

Is CPR always necessary?

A spokesperson for the HSE in Ireland stated that “a person whose heart has stopped is unlikely to survive if CPR is not administered before the arrival of the ambulance service”.

“It is a personal choice if you decide to do CPR,” they added.

Professor Martin Cormican, HSE national lead for healthcare associated infection and antimicrobial resistance, said that “for many people who were willing to carry out CPR it is now more difficult to know what to do because of Covid-19”.

“We understand that this decision is very personal,” the professor said.

“Our advice sets out seven practical steps to reduce the risk while performing CPR, which also gives the person who has collapsed the best chance of survival during the Covid-19 pandemic.

“Remember to ring 112/999 and ask for the ambulance service for any medical emergency.”