St John would like to confirm that ambulance officers continue to resuscitate patients in cardiac arrest and there has been no directive that CPR should not be done on patients with suspected or confirmed COVID-19.
Like all ambulance services in New Zealand, Australia and internationally, we have issued additional instructions to ambulance officers when responding to cardiac arrest patients because of the increased risk of exposure to COVID-19 during resuscitation.
Guidance includes donning additional personal protective equipment (PPE) and alterations to the way that patients are resuscitated (for example, providing ventilation using specific devices and not through a face mask), to reduce the risk of transmission of viral infection, if present.
The reason for the additional instructions is not due to a lack of PPE, it is due to the need to ensure that we optimise the safety of our frontline people who are responding to the patient by reducing exposure to airborne droplets. It is important to minimize any risk to our crews.
Ambulance officers make critical decisions during resuscitation for cardiac arrest, and this includes when it is inappropriate to start resuscitation and when it is appropriate to stop resuscitation. Additional guidance has been provided for patients that are confirmed to have COVID-19, and this advice is that resuscitation should commence provided personnel think it is appropriate to do so.
These instructions have been issued by the St John Clinical Advisory Group, which is led by St John medical director Dr Tony Smith, and were not distributed as a memo but were part of a “live” internal document for ambulance officers that is updated constantly by our clinical staff.
Additionally, St John has provided clear advice to our Fire and Emergency New Zealand (FENZ) colleagues to perform CPR until an ambulance crew arrives on the scene, unless it is very clear that that is not the most appropriate action.
Our Medical Directors are confident this is the best approach for our patients and our staff during the COVID-19 pandemic.
FOR FURTHER INFORMATION CONTACT:
Gerard Campbell
St John Communications Advisor
M: 027 567 2083
E: gerard.campbell@stjohn.org.nz