Recommendations for Cardiopulmonary Resuscitation (CPR) of patients with suspected or confirmed COVID-19

The care for patients suffering from cardiopulmonary arrest in a context of a COVID-19 pandemic has particularities that should be highlighted The following recommendations from the Brazilian Association of Emergency Medicine (ABRAMEDE), the Brazilian Society of Cardiology (SBC) and the Brazilian Association of Intensive Medicine (AMIB) and the Brazilian Society of Anesthesiology (SBA), associations and societies official representatives of specialties affiliated to the Brazilian Medical Association (AMB), aim to guide the various assistant teams, in a context of little solid evidence, maximizing the protection of teams and patients It is essential to wear full Personal Protective Equipment (PPE) for aerosols during the care of Cardiopulmonary Resuscitation (CPR) and it is imperative to consider and treat the potential causes in these patients, especially hypoxia and arrhythmias caused by changes in the QT interval or myocarditis The installation of an advanced invasive airway must be obtained early and the use of High Efficiency Particulate Arrestance (HEPA) filters at the interface with the valve bag is mandatory;situations of occurrence of CPR during mechanical ventilation and in a prone position demand peculiarities that are different from the conventional CPR pattern Faced with the care of a patient diagnosed or suspected of COVID-19, the care follows the national and international protocols and guidelines 2015 ILCOR (International Alliance of Resuscitation Committees), AHA 2019 Guidelines (American Heart Association) and the Update of the Cardiopulmonary Resuscitation and Emergency Care Directive of the Brazilian Society of Cardiology 2019 Resumo A aten��o ao paciente v�tima de parada cardiorrespirat�ria em um contexto de pandemia de COVID-19 possui particularidades que devem ser ressaltadas As seguintes recomenda��es da Associa��o Brasileira de Medicina de Emerg�ncia (ABRAMEDE), Sociedade Brasileira de Cardiologia (SBC), Associa��o de Medicina Intensiva Brasileira (AMIB) e Sociedade Brasileira de Anestesiologia (SBA), associa��es e sociedades representantes oficiais de especialidades afiliadas a Associa��o Medica Brasileira (AMB), t�m por objetivo orientar as diversas equipes assistentes, em um contexto de poucas evid�ncias s�lidas, maximizando a prote��o das equipes e dos pacientes � fundamental a paramenta��o completa com Equipamentos de Prote��o Individual (EPIs) para aeross�is durante o atendimento de Parada Cardiorrespirat�ria (PCR), e imperativo que se considerem e tratem os potenciais causas nesses pacientes, principalmente hip�xia e arritmias causadas por altera��es no intervalo QT ou miocardites A instala��o de via a�rea invasiva avan�ada deve ser obtida precocemente e o uso de filtros High Efficiency Particulate Arrestance (HEPA) na interface com a bolsa-v�lvula � obrigat�rio;situa��es de ocorr�ncia de PCR durante a ventila��o mec�nica e em posi��o pronada demandam peculiaridades distintas do padr�o convencional de PCR Frente ao atendimento de um paciente com diagn�stico ou suspeito de COVID-19, o atendimento segue em acordo com os protocolos e diretrizes nacionais e internacionais 2015 ILCOR (Alian�a Internacional dos Comit�s de Ressuscita��o), Diretrizes AHA 2019 (American Heart Association) e a Atualiza��o da Diretriz de Ressuscita��o Cardiopulmonar e Cuidados de Emerg�ncia da Sociedade Brasileira de Cardiologia 2019