Ebola and CPR

[mandykal, ADN, RN]

Student here doing my research and looking for opinions for those who work or have worked in a hospital settings. What was your policy on Ebola virus and CPR? Was there a special personal protective equipment required or is it just basic goggles, caps, double gloves and gown? or is it something special that resembles a hazmat suit?

Thanks.

[frozenmedic]

I can almost guarantee there isn't an official policy, and you're assuming you actually know the patient has Ebola. If they came in from outside the hospital as a working arrest, and looked like someone dying from a viral hemorrhagic fever, I assume you would put on all the PPE you could immediately find, and go about coding the patient, at unknown great risk to yourself and the facility.

That being said, I have been on a hospital isolation team in the case of Ebola or other serious communicable disease outbreaks. In the case of a patient with known or suspected Ebola for routine patient care we were trained to wear a high level hazmat suit with respirator etc. Because this is such a rare situation, we didn't have a CPR policy. What we did have was a realistic discussion on the potential risk/benefit of performing CPR in this situation.

Consider that a person who has arrested from Ebola likely has severe blood loss from sources including GI tract, mucous membranes, pulmonary tree, skin hemorrhages etc, plus an on-going sepsis picture. This is not an easy clinical picture to fix, combine that with the known terrible survival rates from CPR from sudden cardiac death (which is potentially reversible if due to acute coronary artery occlusion) and you have a situation that is likely non-reversible. While performing CPR, intubation,and whatever other aggressive interventions are required, even with specialty PPE there is likely to be tremendous body fluid exposure risk to personnel, given the realities of Ebola's clinical course in particular. We were taught that there is no PPE designed to prevent transmission of highly infectious diseases under the physical performance of CPR; even the highest level biohazard suits used by researchers doing lab work routinely on these disease assume a very controlled environment without physical exertion. Combine all of this, and what you have is a morally difficult situation, but one nonetheless where CPR is not likely to be offered as an intervention.