Risk of Acquiring Infection During CPR Is Low


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Fox News;November 16, 1998

NEW YORK — The risk of acquiring an infectious disease while performing cardiopulmonary resuscitation is very low, and can be further reduced with simple infection-control measures, U.S. researchers report. Patients who receive CPR within three to four minutes of going into cardiopulmonary arrest are the most likely to survive, research findings suggest.

"Unfortunately, fear of contracting a communicable disease, especially HIV infection, has become a major barrier to immediate response," Drs. George C. Mejicano and Dennis G. Maki, of the University of Wisconsin Medical School in Madison, write.

The researchers, who reviewed more than 200 studies investigating the risk of infection during CPR, summarize their findings in an article in the Nov. 15 issue of the Annals of Internal Medicine.

The probability of acquiring a blood-borne virus — such as the human immunodeficiency virus, hepatitis B virus, or hepatitis C virus — through exposure to the saliva of an infected patient during CPR is "extremely low." And the odds of acquiring cytomegalovirus are "probably not great," the researchers report.

"No cases of HIV, HBV, HCV, or CMV infection transmitted by mouth-to-mouth ventilation have been documented," they write. One study the researchers reviewed estimated the risk of acquiring HIV during mouth-to-mouth contact at between 1 in one million and one in 1 billion.

There have been three documented cases in which health workers appear to have contracted HIV when their skin came in contact with an infected patient's blood. In each case, however "the exposure was heavy and prolonged and the exposed healthcare worker had chapped hands or other possible skin breaks," Mejicano and Maki write.

The more than 200 studies that the researchers reviewed documented only one or two instances in which other infectious agents — such as mycobacterium tuberculosis, Shigella sonnei, Salmonella infantis, Neisseria gonorrhoeae, and Herpes simplex virus — were transmitted from patient to rescuer during CPR. And they found reports of only four instances in which healthcare workers contracted Neisseria meningitidis, a pathogen that causes meningitis.

"The scene of a resuscitation is often chaotic, and healthcare workers engaged in CPR are therefore at risk for exposure to blood-borne pathogens from accidental needlesticks and other sharps injuries," Mejicano and Maki note. Even so, their analysis of 25 studies investigating needlesticks and infection suggests that health workers' risks of acquiring HIV through needlesticks is less than 1 percent, at 0.32 percent.

The use of mouth barriers, procedures for the safe disposal of needles and sharps, immunization against hepatitis B, screening and treatment after exposure to pathogens, and, whenever possible, needleless emergency care, can further reduce an already low risk of contracting infection during CPR, the researchers conclude.

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