Chest compression liberated viral bioaerosol - version 1 [COVID-19]
Research type
Research Study
Full title
Do chest compressions liberate detectable viral bioaerosol during cardiopulmonary resuscitation?
IRAS ID
291228
Contact name
Guy Rutty
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
0 years, 5 months, 31 days
Research summary
When a patient goes into cardiac arrest immediate intervention by the nearest person is required to save life. The Chain of Survival directs the provision of chest compressions (CCs) at the earliest opportunity, as every minute CCs are not provided the chance of survival decreases by 10%. Thus time is a critical element of the Chain of Survival. Currently the world is gripped in the SARS-CoV-2 pandemic which has affected every aspect of everybody’s life, including the provision of cardiopulmonary resuscitation (CPR). Many consider that CCs are an aerosol generating procedure (AGP) and that healthcare workers are at high risk of contracting SARS-CoV-2 (COVID-19) during CPR due to the close proximity they work to the patient. However, the evidence base to support this view is very weak (doi.org/10.1016/j.resuscitation.2020.04.022). If CCs are an AGP, then failure to have adequate respiratory protection would put the general public, first aiders and healthcare professionals at risk of contracting an infection such as COVID-19 whilst tying to save a life. However, if CCs are not an AGP, the delay of 4-5 min while donning airborne-precaution personal protective equipment (PPE) will reduce that chance of survival for the person in arrest despite the lack of risk to the rescuer, i.e. adversely affect the Chain of Survival. The current controversy has caused anxiety among healthcare providers and may have the consequence of decreasing bystander intervention in cardiac arrest. As there is no indication of the current pandemic abating, determining whether or not CCs liberate a detectable viral bioaerosol is very important to every CPR provider worldwide, be it healthcare professionals or members of the general public. We aim to determine whether CCs during CPR liberate a detectable viable viral bioaerosol which could expose CPR providers, particularly at a time of the on-going COVID-19 pandemic, to potential infection.
Summary of Results
We have demonstrated an increase in particle counts within a chamber placed over the nose and mouth of a modified mannikin and consented human cadavers post chest compression chamber sampling. We have also liberated a stimulant bioaerosol from the lungs of these two models into the chamber suggesting that chest compressions of resuscitation can liberate a bioaerosol.REC name
East of England - Cambridge South Research Ethics Committee
REC reference
20/EE/0280
Date of REC Opinion
8 Dec 2020
REC opinion
Further Information Favourable Opinion