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Tijdelijke aanpassingen van de reanimatierichtlijnen bij een daadwerkelijke reanimatie in de praktijk

11 Apr 2020 Geen categorie 10118

In verband met de COVID-19 pandemie

Datum advies: 8 april 2020
De Nederlandse Reanimatie Raad (NRR) heeft in aanvulling op de adviezen tot nu toe de reanimatierichtlijnen verder aangescherpt om verspreiding van het COVID-19 virus tegen te gaan. NRR heeft dit advies met grote zorgvuldigheid opgesteld in samenspraak met Ambulancezorg Nederland, de Nederlandse Vereniging van Medische Managers Ambulancezorg, HartslagNu en het RIVM.
In de huidige crisissituatie wijzigen richtlijnen en inzichten echter voortdurend. In overleg met het RIVM en betrokken partijen zal de NRR bekend maken wanneer de adviezen worden aangepast of ingetrokken.
Wees alert op herziening van deze adviezen.

Het doel van de maatregelen is het risico van besmetting met het coronavirus van de hulpverleners tot het minimum te beperken. En tegelijk willen we de slachtoffers van een circulatiestilstand zo min mogelijk tekort doen. Dit advies geldt voor een beperkte periode.

Wanneer mag je niet reanimeren?
Ga niet naar een reanimatie als:

  • Je je ziek voelt, of iemand in je gezin ziek is.
  • Je behoort tot een hoogrisicogroep.


Hersteld?
Als je hersteld bent, mag je weer aan het werk, dus mag je ook reanimeren.

Aantal hulpverleners betrokken bij de reanimatiepoging

  • Er mogen maximaal 2 hulpverleners (inclusief brandweer/politie) bij een slachtoffer zijn. Anderen staan op minimaal 1,5 meter afstand.
     
  • Pocketmasks, Kiss of Lifes of andere beschermingsmiddelen bij mond-op-mond-beademing, beschermen niet tegen besmetting met het coronavirus. Gebruik ze daarom niet!

 
Aanpassing eerste benadering slachtoffer

  • Raak het hoofd van het slachtoffer niet aan.
     
  • Voor het vaststellen van een normale ademhaling komen “luisteren” en “voelen” te vervallen. Je moet de ademhaling alleen beoordelen door te kijken.
    Controleer de ademhaling niet door te luisteren en te voelen. Open de luchtweg niet voor het beoordelen van de ademhaling.

In de 112-meldkamer is een aangepast beleid om te achterhalen of een slachtoffer mogelijk COVID-19 positief is. Volg de aanwijzingen van de centralist op.

Aanpassing reanimatie
Slachtoffer ZONDER duidelijke of bewezen COVID-19 besmetting

  • Start met ononderbroken borstcompressies en gebruik de AED.
  • Geef geen mond-op-mond/masker beademing.

Slachtoffer MET bewezen of veronderstelde COVID-19 besmetting

  • Gebruik de AED, maar geef geen borstcompressies en geen mond-op-mond/masker beademing.

Na de reanimatie
Desinfecteer je handen en polsen direct na de reanimatie op je werkplek of bij een ambulance of eventuele andere aanwezige hulpverleningsvoertuigen.

Krijg je klachten?
Krijg je in de dagen/weken na de reanimatie klachten die mogelijk duiden op COVID-19? Volg dan de adviezen van het RIVM. Neem zo nodig contact op met je eigen huisarts.

Reanimatie kinderen
De reanimatie bij kinderen is onveranderd. Dit geldt voor kinderen TOT de puberteit. Als je het kind niet kent, maak dan een inschatting of het om een kind of een puber gaat, dit is niet direct aan een specifieke leeftijd te koppelen.

Ambulancepersoneel in beschermende kleding
Wees je ervan bewust dat het ambulancepersoneel altijd in beschermende kleding naar een reanimatie toe zal gaan. Het betekent niet dat het slachtoffer ook daadwerkelijk besmet is.

Aansprakelijkheid
NIET VERGETEN: Wees je ervan bewust dat je niet aansprakelijk bent als je een bepaalde handeling niet uitvoert.

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