TY - JOUR
T1 - First aid during the COVID-19 pandemic
AU - Magnavita, Nicola
AU - Sacco, Angelo
AU - Nucera, Gabriella
AU - Chirico, Francesco
PY - 2020
Y1 - 2020
N2 - Workers spend more than a third of their lifetime in the
workplace [1]. Customers and other visitors also spend a
significant amount of time in workplaces. Health events
requiring urgent intervention may therefore occur in
the workplace. Between 0.3 and 4.7% of out-of-hospital
cardiac arrests [2] (a leading cause of death globally
with an incidence of 55 per 100 000 adults per annum
[3]) occur in the workplace. Other traumatic events
involving workers, customers and the general public
may require cardiopulmonary resuscitation (CPR).
Drowning, which is responsible for 7% of all traumatic
deaths and is the third leading global cause of death
from accidents, is a significant risk in swimming pools
and spas. Globally, the annual estimate of deaths due to
drowning is 372 000, but this may be an underestimate
[4]. Effective first aid is a moral duty for every worker.
In compliance with Article 16 (1) of Directive 89/391/
EEC, employers must appoint trained first aiders to deliver first aid, firefighting and the evacuation of workers.
The resumption of activities after lockdown calls for a
review of workplace first aid.
Although workplace first aid is generally well organized throughout Europe, it has become more challenging due to the COVID-19 pandemic, as the virus poses
a serious risk of infection to both the casualty and the
rescuer. During first aid, rescuer and casualty come into
close contact, especially during CPR. Mouth-to-mouth
resuscitation poses the greatest risk of infection. However,
performing chest compressions also generates aerosols
by passive ventilation [5]. The protection provided by
facial shields/visors and Laerdal-type pocket masks with
one-way filtered valve does not guarantee the safety of
both the rescuer and the casualty.
Following the COVID-19 pandemic, risk assessments
should be reviewed and occupational first-aid services
should be reconfigured. As there may be a shortage of
protective equipment and trained operators, staff must
be properly trained and ready to deal with the challenges
posed by the pandemic. During teaching sessions, social
distancing must be maintained and the number of participants must be limited. Students must have appropriate
personal protective equipment (PPE). Hand-sanitizers
and sanitizing products should be provided for the
cleansing and disinfection of surfaces as well as low-cost
dedicated manikins that can be sanitized before and after
use by each student. Automated External Defibrillator
(AED) training devices must also be sanitized. Careful
resource management can overcome these problems, but
it is more difficult to implement effective safety procedures designed to eliminate the biological risk for the
casualty and the rescuer.
The risk posed by mouth-to-mouth resuscitation
and uncertainty over effective control could lead some
workers to refuse to perform CPR or, should they be infected, to blame their employers for failing to adequately
control the risk. The guidelines for first aid and CPR
should therefore be modified to include additional risk
control measures and recommendations.
Avoiding transmission of infectious diseases during
mouth-to-mouth resuscitation is a problem that was addressed prior to the current pandemic. If the casualty was
infected by HIV, tuberculosis, hepatitis B or SARS, the
2015 European Resuscitation Council (ERC) guidelines
recommended rescuers to use a Laerdal-type disposable
face shield with a low-resistance filter one-way filtered
valve. However, the COVID-19 pandemic has prompted
international and national organizations to update their
guidelines.
If casualties are suspected of having COVID-19, the
updated American Heart Association (AHA) guidelines recommend lay rescuers should perform only
chest compression and defibrillation in adults, and to
carry out full CPR only in children who are at high
risk of respiratory failure. The AHA recommends both
the rescuer and the casualt
AB - Workers spend more than a third of their lifetime in the
workplace [1]. Customers and other visitors also spend a
significant amount of time in workplaces. Health events
requiring urgent intervention may therefore occur in
the workplace. Between 0.3 and 4.7% of out-of-hospital
cardiac arrests [2] (a leading cause of death globally
with an incidence of 55 per 100 000 adults per annum
[3]) occur in the workplace. Other traumatic events
involving workers, customers and the general public
may require cardiopulmonary resuscitation (CPR).
Drowning, which is responsible for 7% of all traumatic
deaths and is the third leading global cause of death
from accidents, is a significant risk in swimming pools
and spas. Globally, the annual estimate of deaths due to
drowning is 372 000, but this may be an underestimate
[4]. Effective first aid is a moral duty for every worker.
In compliance with Article 16 (1) of Directive 89/391/
EEC, employers must appoint trained first aiders to deliver first aid, firefighting and the evacuation of workers.
The resumption of activities after lockdown calls for a
review of workplace first aid.
Although workplace first aid is generally well organized throughout Europe, it has become more challenging due to the COVID-19 pandemic, as the virus poses
a serious risk of infection to both the casualty and the
rescuer. During first aid, rescuer and casualty come into
close contact, especially during CPR. Mouth-to-mouth
resuscitation poses the greatest risk of infection. However,
performing chest compressions also generates aerosols
by passive ventilation [5]. The protection provided by
facial shields/visors and Laerdal-type pocket masks with
one-way filtered valve does not guarantee the safety of
both the rescuer and the casualty.
Following the COVID-19 pandemic, risk assessments
should be reviewed and occupational first-aid services
should be reconfigured. As there may be a shortage of
protective equipment and trained operators, staff must
be properly trained and ready to deal with the challenges
posed by the pandemic. During teaching sessions, social
distancing must be maintained and the number of participants must be limited. Students must have appropriate
personal protective equipment (PPE). Hand-sanitizers
and sanitizing products should be provided for the
cleansing and disinfection of surfaces as well as low-cost
dedicated manikins that can be sanitized before and after
use by each student. Automated External Defibrillator
(AED) training devices must also be sanitized. Careful
resource management can overcome these problems, but
it is more difficult to implement effective safety procedures designed to eliminate the biological risk for the
casualty and the rescuer.
The risk posed by mouth-to-mouth resuscitation
and uncertainty over effective control could lead some
workers to refuse to perform CPR or, should they be infected, to blame their employers for failing to adequately
control the risk. The guidelines for first aid and CPR
should therefore be modified to include additional risk
control measures and recommendations.
Avoiding transmission of infectious diseases during
mouth-to-mouth resuscitation is a problem that was addressed prior to the current pandemic. If the casualty was
infected by HIV, tuberculosis, hepatitis B or SARS, the
2015 European Resuscitation Council (ERC) guidelines
recommended rescuers to use a Laerdal-type disposable
face shield with a low-resistance filter one-way filtered
valve. However, the COVID-19 pandemic has prompted
international and national organizations to update their
guidelines.
If casualties are suspected of having COVID-19, the
updated American Heart Association (AHA) guidelines recommend lay rescuers should perform only
chest compression and defibrillation in adults, and to
carry out full CPR only in children who are at high
risk of respiratory failure. The AHA recommends both
the rescuer and the casualt
KW - Covid-19
KW - First aid
KW - emergency
KW - mask
KW - safety
KW - workplace
KW - Covid-19
KW - First aid
KW - emergency
KW - mask
KW - safety
KW - workplace
UR - http://hdl.handle.net/10807/160431
U2 - 10.1093/occmed/kqaa148
DO - 10.1093/occmed/kqaa148
M3 - Article
SN - 0962-7480
VL - 70
SP - 458
EP - 460
JO - Occupational Medicine
JF - Occupational Medicine
ER -