Cardiopulmonary resuscitation protocol changes during the COVID-19 pandemic: a cross- sectional survey of SOS-KANTO 2017 study

Abstract

Abstract The international guidelines recommend that rescuers balance the urgent needs of care for COVID-19 patients and the protection of healthcare providers from cross-infections. However, little is known about a change in CPR protocol during the Pandemic. The aim of our study is to survey the protocol change and know whether any institution implemented adversely affecting changes in resuscitation. This was a cross-sectional survey study investigating changes in CPR protocol between the pre- COVID-19 pandemic and pandemic period. Online questionnaires were distributed to 41 institutions that participated in the SOS-KANTO 2017 study in January 2021. The survey covered the following three topics: 1) differences in each institution’s cardiopulmonary resuscitation (CPR) protocol; 2) timing of initiation of the new CPR protocol; and 3) airway and infection management protocol of emergency medical services (EMS) and each institution. Of the institutions, 90% implemented protocol changes by April 2020 and 100% by October 2020. However, we found variations in these changes, particularly those regarding airway management; a total of 75% of the institutions answered that they did not modify or change their methods of airway management. Around of the institutions might not have implemented enough strategies to reduce exposure to the COVID-19 virus as recommended by the guidelines as of January 2021. Overall, based on the results of our survey, resuscitation protocols for all participating institutions have been revised, but few has changed protocols to detrimental to OHCA. On the other hand, emergency services showed variation in airway management, with 75% not modifying or changing airway managements.