Subject(s)
Anesthesia, Cardiac Procedures/methods , Anesthesiology/methods , Critical Care/methods , Intensive Care Units , Anesthesia, Cardiac Procedures/trends , Anesthesiology/trends , Betacoronavirus , COVID-19 , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/trends , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Critical Care/trends , Humans , Intensive Care Units/trends , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , SARS-CoV-2ABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the potential impact of the coronavirus disease-2019 (COVID-19) pandemic on out-of-hospital cardiac arrest (OHCA) responses and outcomes in 2 U.S. communities with relatively low infection rates. BACKGROUND: Studies in areas with high COVID-19 infection rates indicate that the pandemic has had direct and indirect effects on community responses to OHCA and negative impacts on survival. Data from areas with lower infection rates are lacking. METHODS: Cases of OHCA in Multnomah County, Oregon, and Ventura County, California, with attempted resuscitation by emergency medical services (EMS) from March 1 to May 31, 2020, and from March 1 to May 31, 2019, were evaluated. RESULTS: In a comparison of 231 OHCA in 2019 to 278 in 2020, the proportion of cases receiving bystander cardiopulmonary resuscitation (CPR) was lower in 2020 (61% to 51%, respectively; p = 0.02), and bystander use of automated external defibrillators (AEDs) declined (5% to 1%, respectively; p = 0.02). EMS response time increased (6.6 ± 2.0 min to 7.6 ± 3.0 min, respectively; p < 0.001), and fewer OHCA cases survived to hospital discharge (14.7% to 7.9%, respectively; p = 0.02). Incidence rates did not change significantly (p > 0.07), and coronavirus infection rates were low (Multnomah County, 143/100,000; Ventura County, 127/100,000 as of May 31) compared to rates of â¼1,600 to 3,000/100,000 in the New York City region at that time. CONCLUSIONS: The community response to OHCA was altered from March to May 2020, with less bystander CPR, delays in EMS response time, and reduced survival from OHCA. These results highlight the pandemic's indirect negative impact on OHCA, even in communities with relatively low incidence of COVID-19 infection, and point to potential opportunities for countering the impact.
Subject(s)
Cardiopulmonary Resuscitation/trends , Emergency Medical Services/trends , Out-of-Hospital Cardiac Arrest/therapy , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , California/epidemiology , Defibrillators , Electric Countershock/trends , Female , Humans , Male , Middle Aged , Oregon/epidemiology , Out-of-Hospital Cardiac Arrest/epidemiology , Out-of-Hospital Cardiac Arrest/mortality , SARS-CoV-2 , Survival Rate/trends , Time Factors , United States/epidemiologySubject(s)
Cardiopulmonary Resuscitation , Coronavirus Infections , Disease Transmission, Infectious/prevention & control , Education, Distance/methods , Education, Nonprofessional/methods , Out-of-Hospital Cardiac Arrest/therapy , Pandemics , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/psychology , Cardiopulmonary Resuscitation/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Humans , Motivation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2Subject(s)
Cardiopulmonary Resuscitation , Coronavirus Infections , Disease Transmission, Infectious/prevention & control , High Fidelity Simulation Training , Pandemics , Pneumonia, Viral , Staff Development , Betacoronavirus/isolation & purification , COVID-19 , Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , High Fidelity Simulation Training/methods , High Fidelity Simulation Training/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2 , Singapore/epidemiology , Staff Development/methods , Staff Development/organization & administration , Teaching/trendsSubject(s)
Cardiopulmonary Resuscitation , Coronavirus Infections , Disease Transmission, Infectious/prevention & control , Education, Nonprofessional/methods , Out-of-Hospital Cardiac Arrest/therapy , Pandemics , Pneumonia, Viral , Teaching/trends , Betacoronavirus/isolation & purification , COVID-19 , Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2ABSTRACT
Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.