HCSA advice to members performing CPR on potential or confirmed Covid-19 patients



Covid-19 and CPR – where you stand
HCSA is aware that clinicians are facing conflict with managers as a result of a gap between Public Health England guidance, which excludes chest compressions as part of CPR from its list of aerosol-generating procedures (AGPs), and guidance from the Resuscitation Council UK which states:

 “1.6. During CPR, there is always the potential for rescuers to be exposed to bodily fluids, and for procedures (e.g. chest compressions, tracheal intubation or ventilation) to generate an infectious aerosol.”

and

“2.6. Full Aerosol Generating Procedure (AGP) Personal Protective Equipment (PPE) must be worn by all members of the resuscitation/emergency team before entering the room. Sets of AGP PPE must be readily available where resuscitation equipment is being locally stored. No chest compressions or airway procedures such as those detailed below should be undertaken without full AGP PPE.”

Some employers have opted to implement the RCUK guidelines, while others have ordered staff to wear less protective PPE as per the PHE guidance. HCSA is currently engaging with both PHE and RCUK to seek a consistent position.

In the meantime, our advice to members is that they should refer to the RCUK guidelines when carrying out chest compressions as part of CPR on patients in any setting.

The PHE guidelines do not take legal precedence over the RCUK guidelines, as some employers have suggested.

This means that for chest compressions as part of CPR, as per the PHE definition of PPE for AGPs:

  1. You should wear “a long-sleeved disposable fluid repellent gown (covering the arms and body) or disposable fluid repellent coveralls, a filtering face piece class 3 (FFP3) respirator, a full-face shield or visor and gloves.”
  2. “Where an AGP is a single procedure, PPE is subject to single use with disposal after each patient contact or procedure as appropriate.”

It is HCSA’s view that you are within your rights to make your own risk assessment and request PPE in accordance with the RCUK guidelines.

If your employer refuses to implement RCUK guidelines then you are advised to contact HCSA immediately.