Indian Resuscitation Council (IRC) suggested guidelines for Comprehensive Cardiopulmonary Life Support (CCLS) for suspected or confirmed coronavirus disease (COVID-19) patient

Management of the recent outbreak of the novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) remains challenging. The challenges are not only limited to its preventive strategies, but also extend to curative treatment, and are amplified during the management of critically ill patients with COVID-19. Older persons with comorbidities like diabetes mellitus, cardiac diseases, hepatic impairment, renal disorders and respiratory pathologies or immune impairing conditions are more vulnerable and have a higher mortality from COVID-19. Earlier, the Indian Resuscitation Council (IRC) had proposed the Comprehensive Cardiopulmonary Life Support (CCLS) for management of cardiac arrest victims in the hospital setting. However, in patients with COVID-19, the guidelines need to be modified,due to various concerns like differing etiology of cardiac arrest, virulence of the virus, risk of its transmission to rescuers, and the need to avoid or minimize aerosolization from the patient due to various interventions. There is limited evidence in these patients, as the SARS-CoV-2 is a novel infection and not much literature is available with high-level evidence related to CPR in patients of COVID-19. These suggested guidelines are a continuum of CCLS guidelines by IRC with an emphasis on the various challenges and concerns being faced during the resuscitative management of COVID-19 patients with cardiopulmonary arrest.

[1]  A. Trikha,et al.  COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National) , 2020, Indian journal of anaesthesia.

[2]  P. Zimetbaum,et al.  Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19). , 2020, JAMA cardiology.

[3]  Peng Sun,et al.  In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China , 2020, Resuscitation.

[4]  L. Fleisher,et al.  Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations , 2020, British Journal of Anaesthesia.

[5]  R. Berg,et al.  Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19 , 2020, Circulation.

[6]  A. Luk,et al.  Cardiovascular Collapse in COVID-19 Infection: The Role of Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) , 2020, CJC Open.

[7]  S. Bajwa,et al.  Indian Society of Anaesthesiologists (ISA National) Advisory and Position Statement regarding COVID-19 , 2020, Indian journal of anaesthesia.

[8]  Weiyi Tan,et al.  Title : The Cardiovascular Burden of Coronavirus Disease 2019 ( COVID-19 ) with a Focus on Congenital Heart Disease Author Names and Affiliations : , 2022 .

[9]  T. Cook,et al.  Consensus guidelines for managing the airway in patients with COVID‐19 , 2020, Anaesthesia.

[10]  Yan Zhao,et al.  Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. , 2020, JAMA.

[11]  G. Gao,et al.  A Novel Coronavirus from Patients with Pneumonia in China, 2019 , 2020, The New England journal of medicine.

[12]  Y. Hu,et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China , 2020, The Lancet.

[13]  J. Divatia,et al.  Compression-only life support (COLS) for cardiopulmonary resuscitation by layperson outside the hospital , 2017, Indian journal of anaesthesia.

[14]  J. Divatia,et al.  The All India Difficult Airway Association 2016 guidelines for tracheal intubation in the Intensive Care Unit , 2016, Indian journal of anaesthesia.

[15]  E. Behr,et al.  Pharmacological treatment of acquired QT prolongation and torsades de pointes. , 2016, British journal of clinical pharmacology.