Chest Compressions and Defibrillation as Aerosolgenerating Procedures

Abstract

SARS-CoV-2 is a highly contagious respiratory pathogen associated with significant mortality in certain patient populations. Patients may be asymptomatic, which causes problems regarding infection control and prevention. Health professionals are required to adhere to strict protocols regarding infection control and personal protective equipment (PPE), particularly when engaging in resuscitation activities thought to be aerosol-generating procedures (AGPs). While adherence to enhanced PPE protocols can delay life-saving interventions, non-adherence may put responders at risk. The aim of this scoping literature review was to establish if chest compressions and defibrillation should be classified as AGPs. Following application of systematic literature search criteria, a limited selection of studies was identified in relation to chest compressions and defibrillation as AGPs. An assumption that endotracheal intubation posed a high risk of nosocomial transmission was noted. Emerging evidence suggests that endotracheal intubation produces fewer aerosol particles than coughing so could be classed as a low-risk-procedure. Because of the lack of adequate prospective studies investigating chest compressions and defibrillation as AGPs, there is a clear need to perform further, well-controlled studies to better understand the aerosol-generating potential of chest compressions and defibrillation.