Use Of Simulation-Based Medical Education For Advanced Resuscitation Of In-Hospital Cardiac Arrest Patients With Suspected Or Confirmed Covid-19

Cardiac arrest is common in critically ill patients with coronavirus disease 2019 (COVID-19) and is associated with poor survival. Simulation is frequently used to evaluate and train code teams with the goal of improving outcomes. All participants engaged in training on donning and doffing of personal protective equipment for suspected or confirmed COVID-1 9 cases. Thereafter, simulations of in-hospital cardiac arrest of patients with COVID-19, socalled protected code blue, were conducted at a quaternary academic centre. The primary endpoint was the mean time-to-defibrillation. A total of 114 patients participated in 33 "protected code blue" simulations over 8 weeks: 10 were senior residents, 17 were attending physicians, 86 were nurses, and 5 were respiratory therapists. Mean time-to-defibrillation was 4.38 minutes. Mean time-to-room entry, time-to-intubation, time-to-first-chest compression and time-to-epinephrine were 2.77, 5.74, 6.31, and 6.20 minutes, respectively; 92.84% of the 16 criteria evaluating Cardiac arrest is common in critically ill patients with COVID-19 and is associated with poor survival.1,2 Among 5019 patients with COVID-19 from 68 intensive care units across the United States, 701 (14.0%) patients suffered in hospital-cardiac arrests, from which only 48 patients (12.0%) survived at discharge.1 More recently, a retrospective cohort of 63 consecutive patients with COVID-19 who suffered in hospital cardiac arrest reported a 0% survival rate at discharge.2 Despite poor reported outcomes in this context, literature regarding the efficiency and the quality of resuscitation efforts is lacking. the proper management of patients with COVID-19 and cardiac arrest were met. Mean time-to-defibrillation was longer than guidelines-expected time during protected code blue simulations. Although adherence to the modified advanced cardiovascular life-support protocol was high, breaches that carry additional infectious risk and reduce the efficacy of the resuscitation team were observed.