AHA Issues 2021 Interim CPR Guidance for Healthcare Providers Treating COVID-19 Patients

​This week, the AHA published new interim CPR guidance for healthcare professionals who treat cardiac arrest patients with suspected or confirmed COVID-19. This latest guidance serves as an update to the 2020 Interim CPR guidance that AHA issued in April 2020.

AHA volunteers reassessed the 2020 Interim CPR guidance considering the evolving nature of the pandemic and increased knowledge about COVID-19. Both resuscitation scientists and healthcare professionals now have a better understanding of COVID-19’s transmissibility. The supply of PPE has stabilized. And an increasing number of both healthcare workers and members of the general public are becoming vaccinated.

These factors contributed to the new recommendations in the updated guidance titled, “2021 Interim Guidance to Healthcare Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates with Suspected or Confirmed Covid-19,” which is now available in the AHA journal, Circulation: Cardiovascular Quality and Outcomes.

AHA collaborated with the following organizations on the guidance: American Academy of Pediatrics; American Association for Respiratory Care; American College of Emergency Physicians; The Society of Critical Care Anesthesiologists; and American Society of Anesthesiologists.

Please note that the updated guidance doesn’t impact CPR training.

What is new?

The 2020 Interim Guidance covered the use of PPE, addressed early intubation, and prioritized oxygenation and ventilation strategies with lower aerosolization risk. The latest guidance includes the following changes:

• New COVID-19 algorithms that incorporate the 2020 AHA Guidelines for CPR and ECC
  • The COVID-19 algorithms differ from the algorithms in the 2020 AHA Guidelines for CPR and ECC by indicating what steps are potentially aerosol-generating procedures and providing suggestions for how to reduce potential risks to healthcare providers who are performing CPR.
• A COVID-19 maternal cardiac arrest algorithm
• Emphasis on providing chest compressions without delay or interruption and defibrillating as soon as possible
• Clarity on when to use PPE and more details on which procedures generate aerosols

In recent months, there has been a spike in cases and hospitalizations attributed to the Delta variant across the globe. Some of this latest guidance should apply to any of the most recent variants that have emerged, according to Dr. Antony Hsu, the chair of the writing group that worked on this new statement.

​Additionally, Dr. Hsu and Dr. Morgan discuss the guidance in a podcast available via the ECC Digital Digest.

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