Published time: 06 May 2020
Authors: Daniel B. Kramer, Bernard Lo and Neal W. Dickert
Keywords: Coronavirus, CPR, pandemic, ethic, Covid-19, emergency medicine
The coronavirus pandemic is forcing clinicians, health care institutions, and public officials to develop crisis standards of care that differ radically from ordinary care for services such as diagnostic testing and mechanical ventilation. Under normal conditions, cardiopulmonary resuscitation (CPR) is provided unless a patient has a do-not-resuscitate (DNR) order that is based on the wishes of the patient or a surrogate. Health care workers are trained to start resuscitation immediately and not wait for more experienced personnel to arrive. It is assumed that intensive care will be available subsequently and that resuscitation attempts pose no substantial risks to clinicians or other patients. Crisis standards during a major surge in Covid-19 patients challenge typical assumptions regarding resuscitation and default provision of CPR.
CPR in the Covid-19 Era — An Ethical Framework