Protected Code Blue
- CPR is considered an AGMP. Take your time. Remember your PPE.
- Place a surgical mask over the patient’s face before initiating CPR.
- Prioritize intubation as part of implementing Advanced Cardiac Life Support (ACLS).
Limitations of CPR
- CPR is performed while the underlying condition is reversed. If the underlying condition is irreversible, CPR will not be beneficial.
- Prolonged resuscitation in a patient without an identifiable reversible cause is not advised.
Patients who meet ALL OF the following criteria do not benefit from continued resuscitative efforts:
- Cardiac arrest NOT witnessed by Emergency Medical Services (EMS) personnel
- No return of spontaneous circulation (ROSC) at any point during prehospital resuscitation.
- Absence of a shockable rhythm (e.g. ventricular fibrillation of ventricular tachycardia) at any point during prehospital resuscitation.
Patients with COVID
- We are expecting to see an increasing number of patients with ARDS in the setting of pandemic COVID-19.
- It is vital that we apply CPR only to those who may benefit. While preliminary in nature, the available data today suggests CPR will be of very limited utility in the setting of COVID-19 infection and cardiac arrest.
- Severe hypoxemia
Cardiac arrest secondary to refractory hypoxemia will not respond to CPR and is considered futile. All efforts should be made to reach out to SDM or POA to inform them and obtain consensus. CPR in these cases should only be performed at the discretion of the physician.
- Refractory Shock
Cardiac arrest secondary to refractory shock will not respond to CPR and is considered futile. All efforts should be made to reach out to SDM or POA to inform them and obtain consensus. CPR in these cases should only be performed at the discretion of the physician.
- Not on optimal therapy
CPR may be indicated in patients who are not yet on optimal therapy with regards to shock or hypoxia.
- Severe hypoxemia