Covid-19 Pandemisinde Farklı Branş Hekimlerinin Kardiyopulmoner Resüsitasyona Yaklaşımlarının Değerlendirilmesi
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Date
2023-04-25Author
Ünver, Ümitcan
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Aim: Guidelines for CPR throughout the COVID-19 pandemic have been presented in order to maintain the quality of CPR while ensuring the safety of the provider during aerosol generating procedures (AGPs). This survey was designed to investigate the compliance of the physicians with these guidelines, during their active work in the care of patients with COVID-19.
Materials and Method: The physicians who performed CPR in the operating room, ICU or wards during the pandemic were included in the study. The survey which was designed according to the guidelines was delivered to the participants online between 01st February-31st December 2021 via the associations of relevant medical branches. The responses were analysed for all the participants and the data was also used to compare different medical branches that actively worked during the pandemic. The participants were grouped into four according to the medical branches of Anaesthesiology and Reanimation, Emergency Medicine, Internal Medicine and others. As the safety measures which have been recommended in the guidelines were discussed individually, the minimum PPEs (gloves, long sleeved gown, N95/N99 mask, face/eye protection) recommended to be worn in AGPs were grouped as ‘major protective measures’ and evaluated separately.
Results: There were 489 participants. The 34.8% of them reported that they at least once performed CPR without any PPE, while this rate was significantly high in the Emergency Medicine (61.4%) (p<0.001). The rate of performing CPR without any PPE was also high in physicians who had performed CPR >10 times (p=0.016), however, the use of FFP3 N99 mask and cap was higher in this group (p=0.026 ve p=0.012). The 44.9% of the participants were compliant with the ‘major protective measures’, and it was similarly <50% in all the medical branches. The difficulty in chest compressions due to PPE was reported at a higher rate in all medical branches, while it was significantly less in Emergency Medicine compared to Anaesthesiology and Reanimation (p=0.016). The education on the CPR for patients during the pandemic was at a rate of 47.4% in all the participants and it was observed that the education was through the documents published by relevant medical societies (56.5%).
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Conclusion: The compliance with the guidelines on CPR during the pandemic was <50%. The education on these guidelines was not mandatory, but depended on voluntariness. It has been concluded that the restriction of face-to-face education, which is the most effective technique in implementing updated recommendations, during the COVID-19 pandemic and the fact that the education were often left to voluntary basis may have caused the problems in compliance with the guidelines in our country, as well as, the others supporting the data in the literature.