International Liaison Committee on Resuscitation (ILCOR) & Covid-19
ILCOR publishes regular and ongoing consensus on science with treatment recommendations informed by rigorous and continuous review of scientific literature focused on resuscitation, cardiac arrest, relevant conditions requiring first aid, related education, implementation strategies and systems of care. These can be found on the ILCOR Science Reviews website.
In response to the COVID-19 global pandemic, ILCOR undertook a systematic review of evidence examining the risk to rescuers from patients in cardiac arrest. The review was posted for public comment on 30th March 2020 and has now been finalised based on feedback received.
- We suggest that chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols (weak recommendation, very low certainty evidence).
- We suggest that in the current COVID-19 pandemic lay rescuers consider compressions and public-access defibrillation (good practice statement).
- We suggest that in the current COVID-19 pandemic, lay rescuers who are willing, trained and able to do so, consider providing rescue breaths to infants and children in addition to chest compressions (good practice statement).
- We suggest that in the current COVID-19 pandemic, healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation (weak recommendation, very low certainty evidence).
- We suggest it may be reasonable for healthcare providers to consider defibrillation before donning personal protective equipment for aerosol generating procedures in situations where the provider assesses the benefits may exceed the risks (good practice statement).
ILCOR’s Basic Life Support, Advanced Life Support and Paediatric Task Forces reviewed their existing guidance in light of that review and provide the following insights and interim measures as good practice statements.
ILCOR hopes this information will be of use to the regional resuscitation councils around the world who support and contribute to our work.
ILCOR COVID-19 Insights and Interim Measures
Resuscitation guidelines around the world use the combination of unresponsiveness and not breathing normally to indicate cardiac arrest. Responsiveness is usually assessed by shaking and shouting the person and assessing for a response. Breathing is usually assessed by opening the airway and looking, listening and feeling for breathing.
In the setting of COVID-19, we continue to suggest checking for responsiveness. When assessing breathing, look for breathing. Do not open the airway or place your face next to the victims’ mouth / nose.
Call emergency services if the patient is unresponsive and not breathing normally.
Previous recommendations and underpinning evidence (Non-COVID)
We recommend that a lone bystander with a mobile phone should dial the EMS, activate the speaker or other hands-free option on the mobile phone and immediately begin continuous compression-only CPR, with EMS dispatcher assistance if required (strong recommendation, very-low-certainty of evidence).