Authors (including presenting author) :
Chan SLD (1), Ko SH (1), BY Chan (1), Leung KH (1), Yip KYL (1), Leung SH (1), Li YC(1)
Affiliation :
(1) KCC FM & GOPC
Introduction :
Cardiopulmonary Resuscitation (CPR) requirement under COVID-19 Emergency State has been updated by prestigious international guidelines lately (1,2,3). The updated practice was promulgated by QEH Resuscitation Committee in Jan 2021 to enhance both staff’s and patient’s safety. The main areas of enhancement include donning of personal protective equipment (PPE) before entering the CPR room, limiting the number of involved personnel in the CPR room, using a HEPA filter for all ventilation device and safely transferring arrested patient to negative pressure room
Objectives :
In accordance to the new infectious control requirement, a timely revision of Department CPR protocol and fact check of the practice is empirically needed. This study tried to summarize the findings of CPR walkthrough among all community-based GOPCs in our department during this enhancement exercise.
Methodology :
All 10 community-based GOPCs of our department were included in the CPR readiness enhancement program carried out from March 2021 to April 2021. One walkthrough session was conducted for each clinic. With reference to the latest promulgated CPR recommendations under COVID-19, the existing CPR protocol of our department had been updated by department Resuscitation Subcommittee. The update involves enhanced staff CPR practice, workflow, CPR equipment and availability of negative pressure room for CPR. Direct observation over CPR readiness walk-through under COVID-19 pandemic was executed by CPR subcommittee core members including 1 Consultant, 1 Associate Consultant and 1 Ward Manager. Standardized audit criteria for reality check covered the following 3 areas: 1. Feasibility of workflow towards designated room for resuscitation. 2. Equipment for CPR for suspected COVID 19 patients. 3. Execution of adjustment of updated CPR protocol March 2021 for suspected COVID-19 patients.
Result & Outcome :
All 10 community-based GOPCs clinics have worked out appropriate means of transporting collapsed patient on site into designated negative pressure room for resuscitation. All resuscitation team members are aware of the requirement of full PPE before entering the negative pressure room. The team has been limited to four members including 1 doctor and 3 nursing staff. Designated area for Donning and Doffing has been identified in all clinics. Full use of HEPA filter in ventilation device during CPR has been demonstrated. Practice of thorough cleansing and air-out of the negative pressure room for at least 1/2 hour by a supporting staff in full PPE has been observed. However, transporting collapsed patient on site onto resuscitation trolley using bed sheets is considered suboptimal. Designated stretcher has been procured for all clinics for this purpose. All clinics are advised to perform actual drill to ensure efficient CPR workflow and to decide on the optimal layout in the negative pressure room. Guideline on staff designation, role delineation and relevant photos on the set up of CPR room is also advised to be properly filed or posted in the CPR room.
