Chest Compressions Protection in the COVID-19 Environment

The Academy is actively monitoring all published resuscitation guidelines regarding the current COVID-19 pandemic while authorizing and drafting related changes to the MPDS in real time. However, because implementing changes in the ProQA software is dependent on the time- consuming construction and testing of these software changes, there may be a lag in the release of related protocol updates. This IAED Statement is intended to avoid that time lag through the issuance of a Protocol 9: Cardiac or Respiratory Arrest / Death Rule, prior to the actual ProQA software release.

This new Rule addresses the recent AHA guidelines published in Resuscitation1 concerning barrier protection from aerosolized particles during the layperson provision of CPR. The guideline states: “A face mask or cloth covering the mouth and nose of the rescuer and/or victim may reduce the risk of transmission to a non-household bystander.”

Agencies are encouraged to circulate this new Rule and train all EMDs providing CPR instruction as soon as possible. The Academy’s Rules Committee has authorized this advice prior to actual software implementation due to the recent AHA guidelines and the emergency needs of the COVID-19 pandemic.


  1. If an airborne-transmitted communicable disease is suspected or confirmed in an adult (≥) cardiac-arrest patient, either through caller information, dispatch screening, or public health, advise the caller to place a light cloth or piece of light clothing over the patient's mouth and nose during compressions to decrease the circulation of aerosolized particles. If Mouth-to-Mouth instructions are advised by protocol (V 1st of C 1st Pathways), for this subset of patients only, follow the Refused M-T-M Pathway.



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