Table 2.

Considerations in Cardiac Arrest

Contagion reduction •Appropriate use of PPE is essential for healthcare personnel safety to reduce risk of infection. •All providers should wear an N-95 respirator (or equivalent) and other appropriate PPE (gown, gloves, eye protection) when performing AGP (i.e., CPR, airway intervention). •Persons not wearing PPE should leave the room/area immediately. •Healthcare personnel can significantly reduce their risk of infection, severe illness, and death through receiving vaccine and booster against SARS-CoV-2.

Resuscitation • General Priorities ο In adults, prioritize chest compressions and defibrillation for shockable rhythms • Chest Compressions ο Initiate compressions by healthcare personnel wearing PPE without delay. ο Mechanical CPR devices should be considered if available to limit provider exposure - note that current data do not demonstrate improved patient outcomes. ο Prioritize and maximize chest compression fraction. • Defibrillation ο Defibrillate as soon as possible for shockable rhythms by healthcare providers wearing PPE without delay. • Oxygenation, Ventilation, & Airway Management ο If agonal breathing is present, passive oxygenation (placement of oral airway with 100% oxygen delivery via face mask) is recommended until HEPA filtered ventilation is possible. ο Utilize a securely attached HEPA filter for all ventilation devices, including bag-mask ventilations, supraglottic airway, and endotracheal tube. ο Use a bag-mask-HEPA filter with tight seal for ventilation until supraglottic or endotracheal airway is established. ο For endotracheal intubation, utilize the provider with a high chance of first-pass success. ο Utilize video laryngoscopy if possible. ο If the intubator is experienced with use of an intubation box, there is insufficient evidence to support their use. ο Pause compressions only to facilitate intubation if necessary. ο Avoid endotracheal administration of medications if possible. ο Reduce closed ventilation circuit disconnections.