For A Child Cpr Involving A Covid-19 Positive Victim

Performing CPR on a Child with Suspected or Confirmed COVID-19: A Guide for Caregivers

The COVID-19 pandemic has presented unprecedented challenges, including adapting life-saving procedures like CPR to minimize infection risk. While the fear of contracting COVID-19 is understandable, the urgency of providing immediate CPR to a child in cardiac arrest remains paramount. This guide provides essential information and safety precautions for performing CPR on a child who is suspected or confirmed to have COVID-19. Remember, acting quickly is crucial; delaying CPR significantly reduces the chances of survival.

Understanding the Risks and Precautions

Performing CPR, even with appropriate precautions, carries a small risk of COVID-19 transmission. However, the risk of death from untreated cardiac arrest far outweighs this risk. The focus should be on minimizing transmission while prioritizing the child's life.

Key Safety Measures:

• Personal Protective Equipment (PPE): The cornerstone of safe CPR in this situation is the use of appropriate PPE. This includes:

  • Gloves: Wear disposable gloves at all times.
  • Eye protection: A face shield or goggles are essential to protect your eyes from potential splashes.
  • Mask: A well-fitted N95 respirator or a surgical mask offers the best protection. If an N95 respirator isn't available, a surgical mask is better than no mask. However, understand that the level of protection is significantly lower.
  • Gown: A disposable gown provides additional protection against bodily fluids.

• Post-CPR Hygiene: Following CPR, meticulous hygiene is critical:

  • Handwashing: Immediately wash your hands thoroughly with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer containing at least 60% alcohol.
  • PPE Disposal: Carefully remove and dispose of all PPE according to your local guidelines and regulations.
  • Self-Monitoring: Monitor yourself for any symptoms of COVID-19, such as fever, cough, or shortness of breath, for at least 14 days following the incident.

• Environmental Considerations:

  • Ventilation: If possible, perform CPR in a well-ventilated area.
  • Surface Disinfection: After the event, disinfect all surfaces that may have come into contact with the child's bodily fluids.

Steps for Performing CPR on a COVID-19 Positive Child

Before starting CPR, always check for responsiveness and breathing:

1. Check for Responsiveness: Gently tap the child's shoulder and shout, "Are you okay?"

2. Check for Breathing: Look for chest rise and fall for no more than 10 seconds. Listen and feel for breath against your cheek.

If the child is unresponsive and not breathing normally or only gasping, immediately call emergency services and begin CPR:

1. Call Emergency Services: Dial your local emergency number (e.g., 911 in the US). Clearly explain the situation: unresponsive child, suspected or confirmed COVID-19, and your location. Keep the phone line open while you perform CPR, if possible.

2. Chest Compressions:

   • Position: Place the child on a firm, flat surface. Kneel beside them.
   • Hand Placement: For children, use two hands to perform chest compressions. Place the heel of one hand on the center of the chest (between the nipples). Place the other hand on top of the first, interlacing your fingers.
   • Compression Depth: Compress the chest to a depth of at least one-third the diameter of the chest. For infants, use two fingers.
   • Compression Rate: Aim for a rate of 100-120 compressions per minute.
   • Allow Chest Recoil: After each compression, allow the chest to fully recoil. Avoid leaning on the chest between compressions.

3. Rescue Breaths:

   • Head Tilt-Chin Lift: Gently tilt the child's head back and lift their chin. This opens the airway.
   • Mouth-to-Mouth or Mouth-to-Mask: If using a bag-valve mask, follow device instructions carefully. If not using a bag-valve mask, give two rescue breaths. Each breath should last about 1 second and make the chest clearly rise. Seal your mouth around the child's mouth and nose to create a tight seal (in most cases, a mask will be preferable for safety).
   • Infant Considerations: For infants, cover their mouth and nose with your mouth.

4. CPR Cycle: Continue the cycle of 30 chest compressions followed by two rescue breaths until:

   • Emergency medical services arrive and take over.
   • The child shows signs of life (e.g., starts breathing normally).
   • You are too exhausted to continue.

Advanced Considerations and Training

• Automated External Defibrillator (AED): If an AED is available, use it as soon as possible. Follow the AED's voice prompts. The AED will analyze the heart rhythm and advise whether a shock is needed.
• Bag-Valve Mask (BVM): A BVM with a one-way valve provides a safer method of delivering rescue breaths than direct mouth-to-mouth, minimizing exposure risk. Proper training is essential for effective use.
• Training: Taking a CPR certification course is essential for anyone who may need to perform CPR. These courses provide hands-on training and practice, enhancing your ability to respond effectively in an emergency. Look for courses that specifically address COVID-19 safety protocols.

Minimizing the Risk of Transmission: Key Takeaways

While the risk of transmission during CPR is relatively low, adhering to these precautions significantly reduces the chance of infection:

• Always use appropriate PPE. This is non-negotiable.
• Practice meticulous hygiene before and after CPR.
• Maintain a strong awareness of your own health. Monitor for symptoms and seek medical advice if necessary.
• Familiarize yourself with local guidelines and protocols.
• Prioritize the child's life. The benefits of immediate CPR far outweigh the risk of transmission.
• Obtain regular CPR training and stay updated on best practices.

This information is for educational purposes only and should not be considered a substitute for professional medical advice. Always follow the guidance of your local health authorities and emergency medical services. The information provided here aims to equip you with knowledge and confidence to respond to a critical situation while minimizing risks. Remember, your quick action can save a life. Staying informed and properly trained will help you to respond effectively and safely.