Possible SARS Coronavirus Transmission during Cardiopulmonary Resuscitation
SARS virus, Resuscitation, Occupational Health, infection control, Transmission, healthcare worker
Infection of healthcare workers with the severe acute respiratory syndrome–associated coronavirus (SARS-CoV) is thought to occur primarily by either contact or large respiratory droplet transmission. However, infrequent healthcare worker infections occurred despite the use of contact and droplet precautions, particularly during certain aerosol-generating medical procedures. We investigated a possible cluster of SARS-CoV infections in healthcare workers who used contact and droplet precautions during attempted cardiopulmonary resuscitation of a SARS patient. Unlike previously reported instances of transmission during aerosol-generating procedures, the index case-patient was unresponsive, and the intubation procedure was performed quickly and without difficulty. However, before intubation, the patient was ventilated with a bag-valve-mask that may have contributed to aerosolization of SARS-CoV. On the basis of the results of this investigation and previous reports of SARS transmission during aerosol-generating procedures, a systematic approach to the problem is outlined, including the use of the following: 1) administrative controls, 2) environmental engineering controls, 3) personal protective equipment, and 4) quality control.
Michael D. Christian, Mona Loutfy, L. Clifford McDonald, Kenneth F. Martinez, Mariana Ofner, Tom Wong, Tamara Wallington, Wayne L Gold, Barbara Mederski, Karen Green, Donald E Low
Centers for Disease Control and Prevention
Infectious and parasitic diseases, Medicine