COVID-19 has made people more reluctant to perform CPR

For almost a year, Public Health officials have told Canadians to live as if the coronavirus was all around us. 

While the message is intended to cut down on the spread of COVID-19, it's also had some unintended consequences. 

The chief learning officer of St. John Ambulance said people are now "far more reluctant" to step in and perform CPR. 

"People were always reluctant to step in and COVID's made it worse," said Shawn McLaren. 

He said St. John Ambulance tries to reassure participants in its first aid courses that performing CPR during a medical emergency can be safe.

McLaren said people have to assess the risk and their own comfort level.

"And if nothing else, we're still encouraging people to call 911 and stay close by, six feet distanced, but stay close by until medical first responders show up."

Melissa Dunfield, training coordinator for St. John Ambulance New Brunswick, said the pandemic has reinforced the importance of proper personal protective equipment. 

"It really does highlight the necessity of PPE and keeping it with you at all times." 

She said well-equipped first aid kits include CPR shields or masks that cover the person's face and provide a one-way tube for air to be blown into the person's mouth, thereby eliminating direct contact. 

But not everyone carries a first aid kit with them, so that option isn't always available. And since the brain begins to shut down after four to six minutes without oxygen, Dunfield said time is of the essence. 

When someone is in cardiac arrest, their best chance of survival is immediate CPR with mouth-to-mouth. 

But Dunfield understands the reluctance of performing mouth-to-mouth on a stranger. 

"I can't tell you you have to do CPR on somebody, I can strongly encourage that this is the reason why we're here. This gives the person the best chance of survival."

She said the bottom line is, "Do what's in your comfort zone." 

"If you are in that worst-case scenario with that stranger, you really don't know anything about them and you are concerned about your own safety and possibly bringing something back to your family. That's a decision I can't make for other people."

She said chest compressions — even without mouth-to-mouth — can still save a person's life. 

The idea is to continue chest compressions until paramedics or other advanced medical help arrives. 

Dunfield said chest compressions can still get air into a person's lungs. She said to imagine squeezing an empty plastic water bottle — air still goes in and out. 

Heart & Stroke has also adapted its guidelines for responding to cardiac arrest. 

The organization says 35,000 people have an out-of-hospital cardiac arrest in Canada every year, and cardiopulmonary resuscitation (CPR) significantly improves the chance of survival.

"In this unusual time of the COVID-19 pandemic, there is concern about the risk of a public responder contracting COVID-19 from a person when providing CPR or using an AED," states the website. 

The organization advises against giving "rescue breaths." 

Its website says, "Provide hands-only CPR: Push hard and fast in the centre of the chest with one hand on top of the other. Think of the beat of Stayin' Alive or about 100-120 beats per minute. Don't stop until the ambulance arrives."

It says rescue breaths should only be considered "if infectious transmission of COVID-19 is not a concern to you (e.g. the person is known to you)."

The Red Cross also advises responders to proceed cautiously. 

"While CPR with breaths has been shown to be beneficial when compared to compression-only CPR, during the COVID-19 outbreak, it is currently recommended that no rescue breaths be performed for adult cardiac arrest patients with confirmed or suspected COVID-19, due to the risk of disease transmission."