Analysis of Seattle EMS data suggests low risk of COVID-19 infection from bystander CPR
University of Washington EMS physicians and researchers analyzed data from more than 1,000 out-of-hospital cardiac arrests in the Seattle area
By Laura French
SEATTLE — An analysis of Seattle EMS and hospital data suggests that the risk of COVID-19 transmission from bystander CPR is low.
A research letter published Thursday in the American Heart Association journal "Circulation" by University of Washington EMS physicians and researchers details how the research team examined data from more than 1,000 out-of-hospital cardiac arrests in the Seattle area.
The team looked at EMS and hospital treatment data, as well as death certificates, to estimate the frequency of COVID-19 infection among out-of-hospital cardiac arrest patients and then estimate the risk of transmission to bystanders who perform hands-only CPR.
From January 1 to April 15, EMS responded to 1,067 out-of-hospital cardiac arrests, of which 478 were treated with CPR by EMS providers. During the active period of COVID-19 (February 26-April 15), EMS responded to 537 (50.3%) out-of-hospital cardiac arrests, of which 230 (48.1%) were EMS treated with CPR.
The researchers said the data showed that as of April 15, COVID-19 was diagnosed in less than 10% of patients who suffered out-of-hospital cardiac arrests.
The authors went on to explain that, assuming the risk of transmission from a COVID-19 patient to a bystander performing hands-only CPR without PPE is 10%, only about one out of every 100 patients (with or without COVID-19) treated with bystander CPR would transmit the virus to the bystander.
The authors add that, given the 1% mortality rate for COVID-19, approximately one in 10,000 bystander CPR events would result in a COVID-19 death, compared with 300 additional lives saved by bystander CPR out of every 10,000 out-of-hospital cardiac arrest events.
“We believe the current findings support telecommunicators and bystanders maintaining the most efficient approach that prioritizes rapid identification of cardiac arrest and immediately proceeds to chest compressions and use of a defibrillator,” the authors write. “Delaying bystander CPR to [put on personal protective equipment] should only be considered when the prevalence of COVID-19 infection is substantially increased.”
Authors of the paper are Michael R. Sayre, M.D.; Leslie M. Barnard, M.P.H.; Catherine R. Counts, Ph.D., M.H.A.; Christopher J. Drucker, Ph.D.; Peter J. Kudenchuk, M.D.; Thomas D. Rea, M.D., M.P.H.; and Mickey S. Eisenberg, M.D., Ph.D.