Worse consequences of out-of-hospital cardiac arrest in the early weeks of the pandemic

According to a new study, the resuscitation rate of cardiac arrest outside the hospital decreased in the first few weeks of the COVID-19 pandemic.

Presented Saturday at the American Heart Association’s Virtual Resuscitation Science Symposium, the study aims to investigate the effects of the COVID-19 pandemic on the consequences of out-of-hospital cardiac arrest in the United States, including areas with relatively low coronavirus deaths. It is said. ..

Researchers examined 52,183 cases of cardiac arrest in the United States between January and April 2019 and 2020. Next, we investigated what would happen to the resuscitation rate of cardiac arrest in the event of a 2020 case in a county that was hit hard by COVID death.

“Did these low survival rates spread across the United States, or were they only in areas with high cases and deaths of (COVID-19)?” Dr. Paul Chan, lead author of the study, said. at the same time JAMA Cardiology..

Rate of pulse return after heart (medical term is continuous recovery of spontaneous circulation, or ROSC) Arrest The first few weeks of the pandemic were 18% lower across the United States compared to early 2019. In areas where COVID-19 mortality was “very high” or “high”, the rate of achieving a pulse was 33% and 21% lower, respectively. However, resuscitation rates were 11% and 15% lower, respectively, even in areas where viral deaths were “very low” or “low.”

“It was unexpected. I’m not entirely sure why it happened,” said Chan, a professor at the University of Missouri’s Kansas City School of Medicine.He co-authored guidance for emergency medical service workers during the COVID-19 pandemic published in the journal in April. Circulation: Cardiovascular quality and results..

According to Chan, due to safety protocols, it may have taken some time for emergency medical teams across the country to attempt to resuscitate the victims. Those protocols have Personal protective equipmentHe said he would suspend CPR, insert the respiratory tract, and not use a method called “bag valve mask ventilation.”

Another possibility of low pulse return is that people with all kinds of illnesses were not treated until it was too late.

“It is quite possible that people suffering from asthma attacks, emphysema attacks, or severe pneumonia during the blockade had (cardiac arrest) at home because they were afraid to go to the emergency room. “Mr. Chan said. “In Kansas City, where I am, the hospital was a ghost town in March and April.”

According to Chan, the study was limited by the lack of complete data from all emergency medical institutions, including details on the quality of CPR.

Factors that may be affected by the pandemic, such as reduced onlooker CPR and defibrillation rates, increased waiting time for EMS arrival, and shorter duration of EMS treatment, suggest reasons for the findings The authors said it has been done. However, they said these factors may not be entirely the cause, saying that bystander CPR rates and EMS latency were similar to 2019.

Further research is needed on out-of-hospital cardiac arrest in New York City and areas hit hard by the pandemic’s “summer surge,” according to Chan. He called for a study of how COVID-related recommendations for EMS workers affect post-pandemic practices in the treatment of out-of-hospital cardiac arrest.

Dr. Catherine Berg, who was not involved in the study, said the findings may be explained by several factors, including policies to protect EMS workers.

“But I think the biggest impact is how completely overwhelmed the healthcare system is in a particular area. The number of patients is so large that there are not enough people to treat everyone as usual. It’s possible, “said the Center for Resuscitation Science at the Beth Israeli Cones Medical Center in Boston.

Mr Berg said he was optimistic that more people would survive out-of-hospital cardiac arrest as the pandemic progressed.

“I think we can better handle how to treat the disease, as some parts of the country are preparing for the next surge. My hope is that (Cardiac arrest) The result will be improved … and I think it has already happened some. ”

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