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Advice for First Aiders around COVID-19

Background

Coronavirus (COVID-19) is a new illness that can affect your lungs and airways.  It is caused by a virus called coronavirus.

As this is a new illness, we do not know exactly how coronavirus spreads from person to person, but we do know that similar viruses spread in cough droplets.

Resuscitation Council UK have issued a statement on COVID-19 in relation to CPR and resuscitation in first aid and community settings.  An outline of the guidance is contained within this statement.

Due to the ever-changing landscape around COVID-19 all individuals are encouraged to seek guidance online at the following sites:

https://www.nhs.uk/conditions/coronavirus-covid-19/

https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response

https://www.resus.org.uk/

Government Advice

As a workplace First Aider you may find that you have close contact with individuals who are symptomatic with potential COVID-19.  First Responders and First Aiders can find the latest advice on providing assistance to someone who is symptomatic and suspected of having COVID-19 can be found on the following site:

https://www.gov.uk/government/publications/novel-coronavirus-2019-ncov-interim-guidance-for-first-responders/interim-guidance-for-first-responders-and-others-in-close-contact-with-symptomatic-people-with-potential-2019-ncov

The headlines are:

People with the following symptoms should be considered to potentially have COVID-19

  • Persistent or continuous cough
  • Fevers or a high temperature of over 37.8℃

Isolation

If you need to provide assistance to an individual that is displaying one or both of these symptoms you should, wherever possible place the in a place that is away from others.  If there is no physically separate room, ask others who are not providing assistance to stay at least 2 metres away from the individual.  If barriers or screens are available, these should be used.

Personal Protective Equipment

You should use and dispose of all Personal Protective Equipment (PPE) according to the instructions and training previously provided by your employer.  Disposable gloves and fluid repellent surgical face masks are recommended if these are available ordinarily, with the addition of disposable plastic aprons and disposable eye protection (such as a face visor or googles) should be worn.

Ensure that you wash your hands thoroughly with soap and water before putting on and taking off PPE.

Hand Hygiene

Good hand hygiene is the most effective barrier to the transmission of COVID-19.  After contact with the individual wash your hands thoroughly with soap and water at the earliest opportunity.  Alcohol hand gel is recommended if soap and water is not available.

Avoid touching your eyes, mouth and nose, unless you have thoroughly cleaned your hands after having contact with the individual.

A guide to effective hand washing can be found at:

https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

Cleaning of the area where assistance was provided

Cleaning of the area should be undertaken in line with the guidance from The World Health Organisation:-

  • Disinfection conducted using diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.

Spillage of body-fluid

  • Keep people away from the area.
  • Use a spill kit if available, using the PPE in the kit or other PPE provided by your employer.
  • If no spill kit is available, place paper towels/roll onto the spill and seek further advice from the emergency services when they arrive.

What to do if you become unwell following contact with someone who may be at risk of COVID-19

Current government advice is for all individuals who experience fevers or a temperature of over  38.8℃ and/or a persistent or continuous cough to stay at home for 7 days.

You do not need to contact 111 to tell them that you are staying at home.

Do not go to a GP surgery, pharmacy or hospital.

You should use the 111 coronavirus service online if:

  • You feel you cannot cope with your symptoms at home
  • Your condition gets worse
  • Your symptoms do not get better after 7 days

The 111 coronavirus service can be accessed using this link:

https://111.nhs.uk/covid-19/

Only call 111 if you cannot get help online.

Cardiopulmonary Resuscitation (CPR) in first aid and community settings

Whenever CPR is carried out, particularly on an unknown victim, there is some risk of cross infection, associated particularly with giving rescue breaths.  Normally, this risk is very small and is set against the inevitability that a person in cardiac arrest will die if no assistance is given.  The first things to do are shout for help and dial 999.

Due to heightened awareness of the possibility that the victim may have COVID-19, Resuscitation Council UK offers this advice:

  • Recognise cardiac arrest by looking for the absence of signs of life and the absence of normal breathing.  Do not listen or feel for breathing by placing your ear and cheek close to the casualty’s mouth.
  • If you are in any doubt about confirming cardiac arrest, the default position is to start chest compressions until help arrives.
  • Make sure an ambulance is on its way.  If COVID-19 is suspected, tell them when you call 999.
  • If there is a perceived risk of infection, rescuers should attempt compression only CPR and early defibrillation until the ambulance arrives.  Put hands together in the middle of the chest and push hard and fast.
  • Early use of a defibrillator significantly increases the person’s chance of survival and does not increase risk of infection.
  • If the rescuer has access to personal protective equipment (gloves, mask, eye protection) this should be worn.
  • After performing compression only CPR, all rescuers should wash their hands thoroughly with soap and water; alcohol based hand gel is a convenient alternative.

Advice for paediatric cardiac arrest and CPR

We are aware that cardiac arrest is unlikely to be caused by a cardiac (heart) problem and is more likely to be a respiratory (lung) one, making ventilations crucial to the child’s chance of survival.  However, for those not trained in paediatric resuscitation, the most important thing is to act quickly to ensure that the child gets the treatment that they need in the critical situation.

For out of hospital cardiac arrest, the importance of calling an ambulance and taking immediate action cannot be stressed enough.  If a child is not breathing normally and no actions are taken, their heart will stop, and full cardiac arrest will occur.  Therefore, if there is any doubt about what to do, this statement should be used.

It is likely that the child/infant having an out-of-hospital cardiac arrest will be known to you.  We accept that doing rescue breaths will increase the risk of transmitting the COVID-19 virus, either to the rescuer or the infant/child.  However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.

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