Suspected or confirmed COVID-19 only

​Ensure you know the goals of care for your patient.

Wear PPE according to local facility and current NSW COVID-19 guidance.

Start BLS immediately using combined contact and droplet precautions.​   

D
↓​ 		Dangers?​​​​​Limit the number of BLS responders in the patient zone at all times.​
R
↓
​Responsive?​Important
Additional responders begin donning airborne PPE
S
↓
​Send for help​CALL 2222 or local​ emergency number
A
↓
​Open airway​Apply oxygen (O2) mask
Opening the airway is not an aerosol generating procedure (AGP) ** 
B 
↓
​Normal breathing?​Warning 
Bag-valve-mask ventilation is an AGP**
Airborne precautions are required​
C
↓
​Start CPR​Warning
Chest compression is a potential AGP**
Airborne precautions are required​
D​Attach defibrillator (AED)​Important
This is NOT an AGP.**  Do not delay.
Defibrillation can precede compressions using contact and droplet precautions

** Aerosol generating procedures (AGP) must not be performed until all responders within the patient zone are wearing PPE for airborne​ precautions.
​​​ ​​​​​​​​[back to top]

Avoid exposure to potentially infectious aerosol

  • limit the number of BLS responders in the patient zone at all times
  • if not in a single room, consider moving the patient, if practical
  • evacuate the area of other patients, visitors and non-responding staff, if possible
  • signs of life, including breathing, can be determined visually from a distance. 

Oxygen therapy and masks during BLS

  • oxygen therapy using a mask is not an AGP and may provide benefit
  • a Hudson mask (6L/min) or non-rebreather mask (10L/min) are both suitable. Covering with a surgical mask over these may provide additional protection against droplet and/or spray contamination.

​Personal protective equipment (PPE)

  • a responder using combined contact and droplet precautions should commence resuscitation immediately
  • all BLS interventions that are not AGPs should be performed without delay
  • do not delay early defibrillation of shockable rhythms
  • responders that arrive and are not wearing PPE, should use contact, droplet and airborne precautions (P2/N95 mask) so that all resuscitation interventions can proceed as soon as possible
  • AGPs that occur commonly during resuscitation are listed below.​​​​​​​​ ​​
Known or potential AGPs
  • high flow O2 therapy nebuliser therapy
  • manual ventilation using a bag-valve-mask (BVM)
  • open airway suctioning
  • chest compressions
  • ​​intubation​​​.​​​

    This information was sourced from the National COVID-19 Clinical Evidence Taskforce, CPR for adults with COVID-19 in healthcare settings - clinical flowcharts (accessed 1 July 2021) See Clinical flowcharts

    Developed by

    Agency for Clinical Innovation (ACI) Intensive Care NSW.

    Consultation 

    Senior clinicians, both medical and nursing, from NSW intensive care units through the:

    Endorsed by

    Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning, NSW Ministry of Health. 

    Reviewed by

    • Senior intensive care specialists​
    • Intensive Care NSW Clinical Director and Network Manager

    For use by

    To support adult intensive care and ward staff with surge in COVID-19 pandemic​.​​​​​​​​​​​​​​​​

    ​​​​​
    Current as at: Wednesday 10 November 2021
    Contact page owner: Health Protection NSW