Table 1 Summary of current intervention strategies of the COVID-19-specific adult BLS guidelines for healthcare providers to maximize the safety and efficacy of resuscitation

Precaution strategies to reduce healthcare providers’ risks from SARS-CoV-2

Resuscitation strategies to reduce healthcare providers’ exposures to SARS-CoV-2 and provide timely care

• Consider resuscitation appropriateness [2, 3, 11] and risk assessment [2, 10]

• Only look at the chest rise and fall to check breathing [2, 10, 11]

• Don appropriate PPE for AGPs before CPR [2, 3, 5, 10, 11]

• Cover the patient’s mouth and nose with a barrier device such as a surgical mask, or equivalent [3, 1210-]

• Limit personnel to only rescuers [2, 10]

• Prioritize defibrillation when indicated [2-5, 1210-]

• Limit unprotected rescuers’ exposure to AGPs, and they should be immediately excused from the CPR room or area [5, 12]

• Prioritize oxygenation and ventilation [2, 10]

• Relieve initial resuscitation personnel with providers wearing appropriate PPE [12]

• Initiate chest compression [3, 11] without delay or interruption while wearing appropriate PPE [5]

• Doff all PPE safely, avoiding self-contamination after CPR [3]

• Use a mechanical chest compression device if available and trained [2, 3, 5, 11, 12]

• Clean, disinfect, or dispose of all the used equipment and nearby surfaces according to local guidelines after resuscitation [3]

• Pause chest compressions during ventilation to minimize the risk of aerosol [2, 3, 10]

• Ventilate with a BVM-HEPA filter using two hands with a tight seal to provide rescue breathing if required [2, 10, 12]

Education strategies for healthcare providers to minimize the potential risks of SARS-CoV-2 transmission

Specific additional resuscitation strategy updates include

• Undergo self-directed web-based e-learning and virtual skill e-training [10]

• Defibrillate as soon as possible if healthcare providers are wearing appropriate PPE for AGPs [5]

• Learn to self-protect against CPR equipment and procedure-related infections [10]

• Prioritize chest compressions and defibrillation when indicated [5, 12]

• Learn to use CPR-related equipment or procedures [10]

• Maximize the chest compression fraction and pause to intubate only if necessary [5, 12]

• Learn how to perform donning and doffing PPE [3, 10, 11]

• Securely attach a HEPA filter to any ventilation device [5, 12]

• Practice CPR procedures with consideration for using PPE [10]

• Consider passive oxygenation overlaid with a surgical mask for agonal breathing until HEPA-filtered ventilation can be provided [5, 12]