Deteriorating Patients

  • Early senior decision making around DNACPR, is vital for both staff, patients, and families.
  • Document decsion making and communications clearly
  • There will be regular updates in “handover” about ICU admission criteria – as these may change over time

CPR (Aerosol Generation Procedure)

  1. Recognise cardiac arrest.
    • Look for the absence of signs of life and normal breathing.
    • Feel for a carotid pulse if trained to do so.
    • Do not listen or feel for breathing
    • If there are any doubts – start chest compressions until help arrives.
    • When calling for help/2222, state the risk of COVID 19. 
  2. Minimum Level 2 PPE; gown, eye protection, gloves and surgical mask/Hood
    • Rhythm assessment
    • Up to 3 shocks(VF/VT)
    • NO CPR
  3. Minimum Level 3 PPE; gown, eye protection, gloves and FFP3 mask/Hood before starting chest compressions
    • No chest compressions or airway procedures such as those detailed below should be undertaken without full AGP PPE.
  4. Start compression-only CPR
    • Avoid mouth-to-mouth ventilation and the use of a pocket mask.
    • Place oxygen face mask on the patient’s face during chest compressions (may limit aerosol spread).
    • Restrict the number of staff in the room (if a single room). Allocate a gatekeeper to do this.
  5. LMA/ETT insertion –  must be carried out by experienced individuals.
  6. Identify and treat any reversible causes 
  7. Post-CPR
    • Dispose of, or clean, all equipment used during CPR
    • Remove PPE safely to avoid self-contamination
    • Hand hygiene has an important role in decreasing transmission.
    • Post resuscitation debrief is important and should be planned.

FULL Resus Council – GUIDE HERE



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