The impacts on bystander and dispatcher-assisted cardiopulmonary resuscitation during COVID-19 pandemic

ABSTRACT

Purpose: The impact of emerging infections disease pandemic such as COVID-19 on bystander CPR performance is not well known. Materials-and-methods: This was an observational database prospectively collected from National Registry for DACPR (dispatcher-assisted CPR), a continuous quality control for OHCA by audio records analyses of EMS calls. The performance of DACPR before and after the COVID-19 epidemic was compared among four individual EMS systems (three metropolitan and one suburban). The bystander chest compressions (BCC) rate prior to the call, successful delivery of BCC after dispatcher-assisted, and the continuity of CC until hand-over by the paramedics after arrival (HCC) as the categorical indicators, and the operational time interval corresponding to call-to-compression were evaluated and analyzed using Pearson's chi-squared test, Independent t-test, and Kruskal–Wallis test with SPSS Version 22. Results: In a total of 3263 eligible patients from four EMS systems, for patients already receiving BCC prior to the call, though showing a tendency of decrease, there were no significant differences after the epidemics (A 3.6% vs. 5.7%, p = 0.13;B 4.5% vs. 6.1%, p = 0.46;C 6.0% vs. 6.6%, p = 0.71;D 6.8% vs. 10.7%, p = 0.59;Total 4.9% vs. 6.4%, p = 0.11). For dispatcher-assisted BCC delivery, a metropolitan (B) significantly decreased and the suburban (D) significantly increased (A 55.0% vs. 56.1%, p = 0.72;B 41.8% vs. 52.3%, p = 0.03;C 60.6% vs. 56.5%, p = 0.19;D 83.0% vs. 60.2%, p < 0.01;Total 56.8% vs. 55.6%, p = 0.53). For continuity of HCC, a metropolitan(C) and the suburban (D) both significantly increased as well as the total cases (A 43.9% vs. 46.4%, p = 0.43;B 28.5% vs. 31.0%, p = 0.56;C 54.0% vs. 40.0%, p < 0.01;D 77.4% vs. 59.3%, p = 0.02;Total 47.4%vs.41.3%, p < 0.01). For call-to-compression interval, all regions showed a tendency to be faster without significance (A 185 vs. 189 s, p = 0.8;B 141 vs. 156 s, p = 0.19;C 173 vs. 182 s, p = 0.12;D 156 vs. 171 s, p = 0.27;Total 164 vs. 172 s, p = 0.19). Conclusions: The impacts of COVID-19 pandemic showed a tendency to decrease BCC prior to dispatcher-assisted, and were significantly varied for dispatcher-assisted BCC among different EMS systems, however the timely BCC would not be delayed. Continuity of BCC even significantly increased under the national continuous auditing.