How to reduce the risk of cross-infection from CPR


Whenever CPR is carried out, there is a chance of cross-infection – especially when giving rescue breaths. In ordinary circumstances the risk of this happening is very small, but in the age of Covid-19 every precaution must be taken. If you are required to perform CPR on an adult, it is recommended that you do not perform rescue breaths or mouth-to-mouth ventilation. As cardiac arrest is not due to lack of oxygen, compression-only CPR may be just as effective as combined ventilation and compression in the first few minutes of an attack.

If the worst should happen and you are required to perform CPR on a child, it is far more likely that chest impressions alone will not be effective. If mouth-to-mouth ventilation is required, you should monitor yourself for Covid-19 symptoms for the following 14 days. The government has provided detailed guidance on what to do if you are a first responder in these circumstances. 

Due to the heightened awareness of Covid-19 and the possibility of infection, Resuscitation Council UK has offered further advice on reducing the risk of infection: 

1.  Recognise the signs

The absence of signs of life and the absence of normal breathing are both telltale signs of cardiac arrest. Do not place your ear or cheek close to the patient’s mouth when you check for breathing. If in doubt about confirming cardiac arrest, the default position is to start chest compressions until help arrives.

2. Alert emergency services immediately

Before you begin CPR, make sure that an ambulance is on the way. If you suspect that the victim has Covid-19, alert the emergency services when you call them. 

3.  Follow Resuscitation UK guidelines

If there is a perceived risk of infection, place a cloth/towel over the victims mouth and nose and attempt compression only CPR and early defibrillation until the ambulance (or advanced care team) arrives. Resuscitation Council UK Guidelines 2015 state “If you are untrained or unable to do rescue breaths, give chest compression-only CPR (i.e. continuous compressions at a rate of at least 100–120 min-1)”. 

4.  If possible, use a defibrillator

Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of infection. Public access defibrillators are normally located in workplaces and public spaces like airports, shopping centres, community centres, and train stations.

5.  If PPE is available, wear it

If the rescuer has access to personal protective equipment (PPE) (e.g. FFP3 face mask, disposable gloves, eye protection), these should be worn. 

6. Follow correct hygiene procedure

After performing compression-only CPR, all rescuers should wash their hands thoroughly with soap and water; alcohol-based hand gel is a convenient alternative. They should also seek advice from the NHS 111 coronavirus advice service or medical adviser.

For more information on using CPR in an emergency, download our guide - How to Save a Life.

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