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The ongoing coronavirus epidemic complicates CPR on patients, doctors say.
Prior to the coronavirus epidemic, successful resuscitations that occurred outside of an ICU setting would typically require subsequent care in an ICU, with some patients requiring a ventilator, according to experts. But what happens when there aren’t available ventilators due to the coronavirus crisis?
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One report in a medical journal says resuscitation should not be required if proper personal protective equipment is unavailable. (iStock)
A new report in the New England Journal of Medicine urges health care systems to rethink standards of crisis care. Unclear standards of care during emergencies can result in fatal consequences and lasting trauma for patients' loved ones.
The report says “transparent policies may help families accept that substantial changes from usual care are necessary and fair,” while also diminishing discrimination based on a patients’ race, sexual orientation, and disability, among other factors.
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Health care workers must wear proper personal protective equipment, or PPE, and should assume patients undergoing resuscitation are COVID-19 positive, the report advises.
Severely ill patients' wishes for a 'do not resuscitate order,' or DNR, must, of course, be respected, which could also reduce constraints on already limited resources.
Upon a patient’s admission to a hospital, discussions about goals of care and CPR preferences must take place and be continually updated.
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Finally, the report claims resuscitation should not be performed if ventilators or critical care beds are not available or if the patient was deemed ineligible for them through a fair hospital triage process.
"Under crisis standards of care, substantial risks to health care workers may outweigh very small chances of providing benefit to a particular patient," the report says, adding that institutions shouldn’t require resuscitation if appropriate PPE, including a face shield for the person performing intubation, isn’t available.
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