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Protecting the Prehospital Professional First Aid Teams from Airborne Viral Particles in the Case of Out-of-Hospital Pediatric Cardiac Arrest during the COVID-19 Pandemic

Published online by Cambridge University Press:  12 May 2020

Sabine Lemoine Open the ORCID record for Sabine Lemoine [Opens in a new window] ,
Frederique Briche ,
Daniel Jost  and
Bertrand Prunet
Sabine Lemoine*
Affiliation:
Paris Fire Brigade, Medical Emergency Department, Paris, France
Frederique Briche
Affiliation:
Paris Fire Brigade, Medical Emergency Department, Paris, France
Daniel Jost
Affiliation:
Paris Fire Brigade, Medical Emergency Department, Paris, France
Bertrand Prunet
Affiliation:
Paris Fire Brigade, Medical Emergency Department, Paris, France
*
Correspondence: Sabine Lemoine, MD, Paris Fire Brigade, Medical Emergency Department, 1 place Jules Renard 75 017ParisFrance, E-mail: sabine.lemoine@pompiersparis.fr
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Abstract

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Type
Letter to the Editor
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 4 , August 2020 , pp. 467
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine

To the Editor,

The pediatric 2019 novel coronavirus disease (COVID-19) cases report mostly asymptomatic or mild infections, with a better prognosis than in adults.Reference Hagman1,Reference Dong, Mo and Hu2 Any pediatric victim who dies from COVID-19 has a significant media impact. These pediatric COVID-19 cardiac arrests occur mostly in intra-hospital settings. To date, we have not found any publication on the prehospital management of COVID-19 pediatric out-of-hospital cardiac arrest (OHCA) by Basic Life Support (BLS) teams (personal systematic review).

In Paris, France, the Fire Brigade Prehospital Rescue System treats approximately 50 pediatric OHCA per year. From March 20, 2020 to April 7, 2020, two children benefited from prehospital cardiopulmonary resuscitation by a BLS team with an unknown etiology.

During the pandemic, in the case of pediatric OHCA whose etiology is definitely not a COVID-19 infection, children should be considered in all cases as potential carriers of COVID-19, and therefore as contaminants as a symptomatic adult, particularly from nasopharyngeal and stool excretion.Reference Hagman1

We are focusing on raising awareness among prehospital teams working on pediatric OHCAs about the need to systematically protect themselves regardless of the cause of pediatric OHCA, and routinely wear personal protective equipment (gloves, filtering face piece [FFP2] respirators, goggles, and long-sleeved gown), especially since there are still uncertainties about the spread of airborne viral particles during resuscitation procedures such as chest compressions, defibrillation, insufflation maneuvers, tracheal intubation, and oral and pharyngeal aspirations.Reference Tran, Cimon, Severn, Pessoa-Silva and Conly3,Reference Mahase and Kmietowicz4

The International Liaison Committee will reach a consensus on the science of the balance between therapeutic benefit and risk of contamination for each of these procedures, also for pediatric cases.

Conflicts of interest/funding

none

References

Hagman, SFH.COVID-19 in children: more than meets the eye. Travel Med Infect Dis. 2020; epub ahead of print.CrossRefGoogle Scholar
Dong, Y, Mo, X, Hu, Y, et al. Epidemiological characteristics of 2,143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020; epub pre-publication ahead of print.Google Scholar
Tran, K, Cimon, K, Severn, M, Pessoa-Silva, CL, Conly, J.Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. 2012;7:e35797.CrossRefGoogle ScholarPubMed
Mahase, E, Kmietowicz, Z.Covid-19: doctors are told not to perform CPR on patients in cardiac arrest. BMJ. 2020;368:m1282.CrossRefGoogle Scholar