Adult Advanced Life Support for COVID-19

patients – Acute hospital settings

Conversations and decisions on

emergency treatment completed
Phase 1

and documented

DNACPR

Yes No

Unresponsive and not

End of life care
breathing normally

Call resuscitation team

State COVID-19

Assess rhythm
At least Level 2 PPE
Phase 2

Shockable Return of spontaneous Non-shockable

(VF/Pulseless VT) circulation (PEA/Asystole)

Immediate post cardiac

Up to 3 shocks arrest treatment
• Use ABCDE approach
• Aim for SpO2 of 94-98%
• Aim for normal PaCO2
• 12-lead ECG
• Treat precipitating cause
•
AGP PPE

Targeted temperature
Phase 3

Don PPE Don PPE

management
CPR for 2 min • AGP PPE if AGP CPR for 2 min
Minimise interruptions Minimise interruptions
interventions

During CPR Recommended PPE Consider

• Ensure high quality chest compressions Level 2 PPE • Ultrasound imaging
• Minimise interruptions to compressions • Disposable gloves
• Mechanical chest
• Give oxygen • Disposable apron
• Consider reversible causes 4Hs and 4Ts • Fluid resistant surgical mask compressions to
• Use waveform capnography • Eye protection facilitate transfer/
• Continuous compressions when advanced treatment
airway in place Level 3 AGP (aerosol generating
• Coronary angiography
• Use a viral filter with any ventilation device, procedures) PPE
including BVM device, SGA or ETtube • Disposable gloves and percutaneous
• Vascular access (IV or IO) • Disposable gown coronary intervention
• Give adrenaline every 3-5 min • Filtering face piece (FFP3) respirator • Extracorporeal CPR
• Give amiodarone after 3 shocks • Eye protection
30/04/2020