Background The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA). Methods OHCA of medical origins identified from the French National Cardiac Arrest Registry between March 1st and April 31st 2020 (COVID-19 period), were analysed. Different resuscitation characteristics were compared with the same period from the previous year (non-COVID-19 period). Results Overall, 1005 OHCA during the COVID-19 period and 1620 during the non-COVID-19 period were compared. During the COVID-19 period, bystanders and first aid providers initiated CPR less frequently (49.8% versus 54.9%; difference, − 5.1 percentage points [95% CI, − 9.1 to − 1.2]; and 84.3% vs. 88.7%; difference, − 4.4 percentage points [95% CI, − 7.1 to − 1.6]; respectively) as did mobile medical teams (67.3% vs. 75.0%; difference, − 7.7 percentage points [95% CI, − 11.3 to − 4.1]). First aid providers used defibrillators less often (66.0% vs. 74.1%; difference, − 8.2 percentage points [95% CI, − 11.8 to − 4.6]). Return of spontaneous circulation (ROSC) and D30 survival were lower during the COVID-19 period (19.5% vs. 25.3%; difference, − 5.8 percentage points [95% CI, − 9.0 to − 2.5]; and 2.8% vs. 6.4%; difference, − 3.6 percentage points [95% CI, − 5.2 to − 1.9]; respectively). Conclusions During the COVID-19 period, we observed a decrease in CPR initiation regardless of whether patients were suspected of SARS-CoV-2 infection or not. In the current atmosphere, it is important to communicate good resuscitation practices to avoid drastic and lasting reductions in survival rates after an OHCA.

No abstract

No abstract

Background Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest in Europe but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe European Emergency Medical Systems, particularly from the perspective of country and ambulance service characteristics, cardiac arrest identification, dispatch, treatment, and monitoring. Methods An online questionnaire with 51 questions about ambulance and dispatch characteristics, on-scene management of cardiac arrest and the availability and dataset in cardiac arrest registries, was sent to all national coordinators who participated in the European Registry of Cardiac Arrest studies. In addition, individual invitations were sent to the remaining European countries. Results Participants from 28 European countries responded to the questionnaire. Results were combined with official information on population density. Overall, the number of Emergency Medical Service missions, level of training of personnel, availability of Helicopter Emergency Medical Services and the involvement of first responders varied across and within countries. There were similarities in team training, availability of key resuscitation equipment and permission for ongoing performance of cardiopulmonary resuscitation during transported. The quality of reporting to cardiac arrest registries varied, as well as the data availability in the registries. Conclusions Throughout Europe there are important differences in Emergency Medical Service systems and the response to out-of-hospital cardiac arrest. Explaining these differences is complicated due to significant variation in how variables are reported to and used in registries.