First aid during the COVID-19 pandemic

Nicola Magnavita, Angelo Sacco, Gabriella Nucera, Francesco Chirico

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

6 Citazioni (Scopus)


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
Lingua originaleEnglish
pagine (da-a)458-460
Numero di pagine3
RivistaOccupational Medicine
Stato di pubblicazionePubblicato - 2020


  • Covid-19
  • First aid
  • emergency
  • mask
  • safety
  • workplace


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