Michigan
*EMERGENCY* SPECIAL OPERATIONS
CARDIAC ARREST IN A PATIENT WITH
SUSPECTED COVID-19 CRISIS STANDARDS OF CARE
Initial Date: 03/23/2020
Revised Date: Section 10-21
MCA Name:
MCA Board Approval Date: Page 1 of 1
MCA Implementation Date:
Protocol Source/References: https://www.cdc.gov/infectioncontrol/guidelines/isolation/precautions.html
Cardiac Arrest in a Patient with Suspected COVID-19 Crisis Standards of Care
I. Applicable patients are patients in cardiac arrest with known previous symptoms of
respiratory illness and fever.
II. Personal Protective Equipment
A. Standard, contact, and airborne precautions
B. CPR and assisting ventilations are aerosolized procedures. N95 masks or equivalent are
required. Do not perform CPR without respiratory precautions in place.
III. Treatment
A. For patients with no known fever or respiratory illness, follow General Cardiac Arrest
Protocol.
B. For arrests of patients with known recent history of respiratory illness and fever, treat
according to General Cardiac Arrest Protocol EXCEPT:
i. Airway interventions will be limited to BLS procedures, including supraglottic
airway. DO NOT INTUBATE.
ii. When CPR is being performed, only necessary personnel should be next to the
patient. Personnel should distance themselves when not performing
interventions.
iii. If no return of spontaneous circulation (ROSC) within 10 minutes of resuscitation,
contact medical control for possible termination orders.
iv. Patients in continuous cardiac arrest WILL NOT BE TRANSPORTED, regardless of
mechanical CPR device. Resuscitation will either be terminated on scene or ROSC
sustained (continued palpable pulse and systolic BP ≥60 mmHg for >5 minutes)
BEFORE moving the patient to the patient compartment of a vehicle.
C. For witnessed arrests inside the patient care compartment:
i. Pull vehicle to the side of the road and perform resuscitation in full PPE, with
doors OPEN.
ii. If patient has mechanical CPR device in place and has lost ROSC, the device may
be resumed with continued transport to the hospital, as long as all personnel in
the patient compartment have sufficient respiratory PPE in place.
