Guidance: COVID-19

Update to Resuscitation Council UK (RCUK) guidance for practice

Cardiopulmonary resuscitation (including chest compressions and ventilations) is a critical intervention to save lives – without which many thousands of lives will be lost each year. 

Throughout the COVID-19 pandemic, RCUK has regularly reviewed its guidance based on published evidence, seeking to balance the delivery of high-quality treatment to patients whilst maintaining staff/rescuer safety. 

Recently published evidence suggests that COVID-19 is predominantly transmitted via the aerosol route as opposed to direct contact and via fomites. With this in mind, we have amended our guidance for health care staff to prioritise protection against the aerosol route of transmission.

The risk associated with COVID-19 has decreased because the majority of the population have been immunised, and more effective treatments and less virulent strains of COVID-19 now predominate.  Widespread community testing programmes have stopped, making it less likely that members of the public will know if someone has COVID-19.   

New evidence has emerged suggesting a low likelihood that airway management manoeuvres are aerosol generating, leading to the removal of airway management manoeuvres from the list of aerosol generating procedures (AGP).

We await further evidence on whether chest compressions generate aerosol. Until such evidence emerges we remain concerned that the provision of chest compressions and the proximity of the rescuer to the patient may constitute a risk of aerosol transmission. 
In light of this new information we recommend:

  • the curriculum for training members of the public and healthcare professionals reverts to the guidance set out in our quality standards
  • members of the public and healthcare professionals follow our 2021 guidelines for resuscitation
  • for those working in healthcare settings, the use of FFP3 masks or respirators as well as eye protection is still recommended when performing chest compressions for patients with suspected or confirmed COVID-19. AGP PPE, in particular FFP3 mask/respirator and eye protection, should be donned as swiftly as possible to avoid any delays in treatment.

We will update our life support course materials in line with the above amended recommendations. 

This guidance is intended to be used by Trust Resuscitation Committees and similar governance bodies to inform updated clinical practice.


Published: 10 August 2022