Cardiopulmonary resuscitation in the exceptional COVID-19 epidemic circumstances

Uvod: Kardiopulmonalna reanimacija kot že tako obremenjujoče stanje v kliničnem okolju za izvajalca in vse druge sodelujoče predstavlja še večji napor v času izrednih razmer, kot je epidemija COVID-19. Proces reanimacije, ki je določen s kliničnimi smernicami, je zaradi epidemioloških razmer zahteval določene prilagoditve. Glavni poudarek pri reanimaciji pacienta z okužbo COVID-19 je zaščita izvajalca, a ga zaradi njenih funkcionalnih lastnosti dostikrat tudi ovira. Namen: V sklopu diplomskega dela želimo predstaviti kardiopulmonalno reanimacijo kot proces dela pri pacientu s potrjeno okužbo s COVID-19, predstaviti razlike v smernicah za delo med reanimacijo v času razmer COVID-19predstaviti vlogo osebne varovalne opreme in izzivi pri uporabi le-te v času reanimacije pri pacientu s potrjeno okužbo s COVID-19 ter opredeliti specifiko dela – reanimacije ter vlogo medicinske sestre/zdravstvenika. Metode dela: Uporabili smo deskriptivno metodo dela. Izveden je bil pregled strokovne znanstvene literature v domačem in tujem jeziku. Literatura je bila pridobljena iz sistema različnih podatkovnih baz, kot so CINAHL, Medine, PubMed, ScienceDirect, ter s pomočjo iskalnika DiKul. Izbrana je bila literatura objavljena med letoma 2011 in 2021. Rezultati: Smernice in protokoli za izvajanje reanimacije COVID-19 pozitivnega pacienta se vsebinsko bistveno ne razlikujejo v primerjavi s smernicami za reanimacijo COVID-19 negativnega pacienta. Te vsebujejo priporočila o prilagoditvah določenih standardnih posegov in intervencij, z namenom zajezitve oziroma omejitve širjenja okužbe. Osebna varovalna oprema je ključni element zaščite izvajalca v izrednih razmerah, kot je trenutna epidemija COVID-19, zato je pomembno, da so zdravstveni delavci usposobljeni za njeno pravilno in dosledno uporabo. Uporaba osebne varovalne opreme, kot je predpisana za obravnavo pacientov s COVID-19, je za zdravstvene delavce tudi izziv. Med reanimacijo privede do hitrejše utrudljivosti izvajalcev, kar se odraža tudi na kakovosti procesa reanimacije. Razprava in zaključek: Epidemija COVID-19 nalaga na že tako obremenjen zdravstveni kader še dodaten stres in odgovornost. Čeprav takšne izredne razmere prinašajo v klinična okolja spremembe, mora stroka stremeti k temu, da ob teh nenadnih spremembah poskrbi za udobnost in varnost zdravstvenih delavcev. Edukacija in klinične raziskave, ki obravnavajo proces reanimacije v sklopu trenutne epidemije, ne bodo le poskrbele za zagotavljanje kakovostnih kliničnih obravnav, ampak prinašajo tudi ozaveščanje in pripravljenost na podobne razmere v prihodnosti.Introduction: Cardiopulmonary resuscitation presents a highly demanding intervention for all included. This particular medical intervention has become even more stressful in regard to the COVID-19 pandemic. Among others, cardiopulmonary resuscitation arranged by clinical guidelines, has been customized concerning the pandemic. One issue of great importance in the cardiopulmonary resuscitation of COVID-19 patients is personal protective equipment, which often presents an obstacle for medical staff due to its limited functional properties. Purpose: In this diploma, the process of cardiopulmonary resuscitation of COVID-19 patients will be presented and its differences from cardiopulmonary resuscitation of noninfectious patients in a clinical environment. Furthermore, the role and challenges of personal protective equipment will be discussed, as well as the role of the nurse in the process. Methods: This research used the descriptive method. Both foreign and domestic professional and scientific literature was reviewed from databases such as CINAHL, Medline, PubMed, and ScienceDirect with the assistance of the DiKul browser. The selected literature was published between 2011 and 2021. Results: Guidelines and protocols for cardiopulmonary resuscitation of COVID-19 patients and noninfectious patients do not differ significantly. Latter guidelines and protocols contain some adaptations regarding methods to stop or minimize the spread of disease. Personal protective equipment and its correct use presents a key priority in nursing care. The importance of correct and consistent use of personal protective equipment and adequate education is critical, although this might present a significant challenge and might consequently result in a lack of resuscitation process quality. Discussion and conclusion: The COVID-19 epidemy additionally exhaust overloaded medical staff and impose more responsibilitytherefore, it is necessary to take care of the safety and comfort of the medical staff regarding changes brought on by epidemy. Education and clinical research on resuscitation during COVID-19 will not only provide a superior quality of medical treatment but also brings awareness for future similar situations