Follow up to AGP article and cardiac arrest management from 25th April

Dr Tom Davis

Please find the below response from Dr. Tom Davis following the recent clinical update regarding cardiac arrest management during COVID:

Firstly, a thank you to all of you who have taken the time to read the latest expert guidance issued by the PHE and the Trust position regarding cardiac arrest management during COVID.

On reading your replies, I understand that a number of questions remain as to why the Trust are recommending the PHE evidence based approach that conflicts with other professional bodies in relation to chest compressions/defibrillation and whether they are considered an AGP or not.

As indicated in my previous update, the guidance issued by PHE is based on an evidence review and consensus statement issued by the ‘New and Emerging Respiratory Virus Threats Advisory Group’ (NERVTAG). Their conclusion is that chest compressions will not be added to the list of AGPs.

Any decision my clinical team and I undertake aims to look at several supportive and conflicting statements, in order to make an informed decision that is proportionate and appropriate.  Please find below a number of recently released links that provide the evidence-based position and decision making taken by NERVTAG which is fully supported by PHE and the Trust.

I wish to assure you that my clinical team and I continue to monitor the evidence released and continue to engage with my ambulance service medical director colleagues through the AACE group NasMed.   Currently, the agreed position is that we will continue to follow PHE guidance as it published, and our current guidance remains the same at this stage.

Thank you again for raising your queries and I sincerely appreciate all for the efforts you are undertaking to meet the needs of our patients.  Both the safety of you and the patient  is at the forefront of our clinical decisions and to confirm the current position is that chest compressions and defibrillation are not considered to be AGPs and can be undertaken by a first responder wearing level 2 PPE and placing a surgical or oxygen mask on the patient.  This attempts to minimise any delay to time critical treatment while at the same time reducing the risk to the responder of exposure and before secondary responders in level 3 PPE can take over and commence full advanced life support which would involve AGPs.

Dr Tom Davis
Medical Director

Published 28th April 2020

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