Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan

Nishiyama, Chika; Kiyohara, Kosuke; Iwami, Taku; Hayashida, Sumito; Kiguchi, Takeyuki; Matsuyama, Tasuku; Katayama, Yusuke; Shimazu, Takeshi; Kitamura, Tetsuhisa

doi:10.1016/j.resplu.2021.100088

Cited by 30 publications

(62 citation statements)

References 13 publications

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“…In most studies, no signi cant differences were reported in terms of sex ratios, similar to our ndings, but some studies have reported signi cantly higher patient ages during the pandemic period. 16,18,24 This result contrasts with our ndings and those of Rosell et al, 25 in both cases showing lower ages in this patient population, although usually not signi cantly so. The COVID-19 pandemic has clearly in uenced all aspects of life, both because of its direct health effects and because of home lockdown-related measures implemented to varying degrees.…”

Section: Discussioncontrasting

confidence: 90%

“…As described in other studies, 5,19,6,20,16,17,21,23,24,25,26 we found that OHCA survival at hospital admission was signi cantly reduced. One prediction might have been that as the rst wave ended and COVID-19 incidence fell, the survival rate would have improved; however, it remained low, with no signi cant changes during the successive waves (Fig.…”

Section: Discussionsupporting

confidence: 86%

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Impact of Different Waves of COVID-19 on Emergency Medical Services and Out-of-hospital Cardiopulmonary Arrest in Madrid, Spain

Pascual

Monge-Martín

González-León

et al. 2021

Preprint

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Background: COVID-19 has led to decreased survival of out-of-hospital cardiorespiratory arrest (OHCA). We analysed the impact of the first COVID-19 pandemic year on emergency medical services and OHCA care compared with the previous year.Methods: Data for this observational study were collected for OHCAs attended by the SUMMA 112 emergency service during March 2019 to March 2021. We compared data covering 15 March 2020–14 March 2021 (pandemic year) to retrospective data covering 15 March 2019–14 March 2020 (non-pandemic year). Results: During the pandemic period, 1743 OHCA patients were attended, compared to 1781 during the non-pandemic year. Median patient age during the pandemic period was lower than in the non-pandemic period (71 vs 72, p=0·037). Emergency services response activation time increased during the pandemic year, to 3 minutes, 16 seconds from 2 minutes, 48 seconds in the non-pandemic period (p=0·001). Time to arrival at the scene also increased during the pandemic (12 minutes vs 11 minutes, 25 seconds before the pandemic; p=0·001). The percentage of OHCAs in which resuscitation was attempted was lower during the pandemic (59·4% vs 62·9%, p=0·034), as were survival on hospital arrival (30·3% vs 34·6%, p=0·04). Differences in response activation time (p=0·003) and scene arrival times (p=0·003) were greater during the first pandemic wave compared with the later phases. Conclusions: The different phases of the pandemic variably affected OHCA care. The first wave led to longer resource activation, increased home events and scene arrival times, as well as lower patient survival.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

Impact of Different Waves of COVID-19 on Emergency Medical Services and Out-of-hospital Cardiopulmonary Arrest in Madrid, Spain

Pascual

Monge-Martín

González-León

et al. 2021

Preprint

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“…A flow diagram showing stages of database search and study selection is shown in Figure 1. Twenty-seven studies reported OHCA outcomes in pre-vs. intra-COVID-19 periods [23,24,[26][27][28][29]31,33,35,[37][38][39][40][41][42][44][45][46][47][48][49][50][51][52][53], and OHCA outcomes in SARS-CoV-2-positive vs. -negative patients were reported in seven trials [25,30,32,34,36,43,51]. Characteristics of the individual studies are presented in Tables S1 and S2.…”

Section: Characteristics Of Studies Included In the Meta-analysismentioning

confidence: 99%

The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis

Bielski

Szarpak²,

Jaguszewski

et al. 2021

JCM

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Cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Because the COVID-19 pandemic may have impacted mortality and morbidity, both on an individual level and the health care system as a whole, our purpose was to determine rates of OHCA survival since the onset of the SARS-CoV2 pandemic. We conducted a systematic review and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes according to the PRISMA guidelines. We searched the literature using PubMed, Scopus, Web of Science and Cochrane Central Register for Controlled Trials databases from inception to September 2021 and identified 1775 potentially relevant studies, of which thirty-one articles totaling 88,188 patients were included in this meta-analysis. Prehospital return of spontaneous circulation (ROSC) in pre-COVID-19 and COVID-19 periods was 12.3% vs. 8.9%, respectively (OR = 1.40; 95%CI: 1.06–1.87; p < 0.001). Survival to hospital discharge in pre- vs. intra-COVID-19 periods was 11.5% vs. 8.2% (OR = 1.57; 95%CI: 1.37–1.79; p < 0.001). A similar dependency was observed in the case of survival to hospital discharge with the Cerebral Performance Category (CPC) 1–2 (6.7% vs. 4.0%; OR = 1.71; 95%CI: 1.35–2.15; p < 0.001), as well as in the 30-day survival rate (9.2% vs. 6.4%; OR = 1.63; 95%CI: 1.13–2.36; p = 0.009). In conclusion, prognosis of OHCA is usually poor and even worse during COVID-19.

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“…Increasing safety and motivation in lay rescuers is vital as bystander CPR and public location of emergencies were reported to be independent prognostic factors for survival to hospital discharge in OHCA patients [16] . If the device is stored together with AEDs in public locations the device would be on hand in approximately 5% to 10% of cases [17] .…”

Section: Consequences Of the Hypothesis And Discussionmentioning

confidence: 99%

Barrier resuscitation by lay rescuers during COVID-19 pandemic

Lederer¹,

Isser²

2021

Medical Hypotheses

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Aerosols generated from chest compressions and ventilation attempts in patients with cardiac arrest may cause airborne infections. Accordingly, the interim international resuscitation guidelines have restricted basic life support by lay rescuers to compression only and the use of an automated external defibrillator during the COVID-19 pandemic. Although these measures may diminish the risk of infection for laypersons, the missing respiratory support can be detrimental for patients with hypoxia-related cardiac arrest. To overcome this shortcoming we want to introduce a special tool that allows ventilation during barrier resuscitation by laypersons. We hypothesize that the application of a device made of a polyvinyl chloride shield with a centrally installed S-shaped ventilation pipe with integrated filter can provide adequate ventilation while concurrently protecting patient and rescuer from airborne agents. Aerosols from air leakage are removed by adhesion and drainage below the barrier. No specific training other than basic life support is needed. We suggest that a tool of this kind be considered essential equipment and stored together with disposable gloves in public access locations.

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Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan

Cited by 30 publications

References 13 publications

Impact of Different Waves of COVID-19 on Emergency Medical Services and Out-of-hospital Cardiopulmonary Arrest in Madrid, Spain

Impact of Different Waves of COVID-19 on Emergency Medical Services and Out-of-hospital Cardiopulmonary Arrest in Madrid, Spain

The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis

Barrier resuscitation by lay rescuers during COVID-19 pandemic

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