Observational study on implications of the COVID-19-pandemic for cardiopulmonary resuscitation in out-of-hospital cardiac arrest: qualitative and quantitative insights from a model region in Germany

Domagoj Damjanovic, Jan Steffen Pooth, Rebecca Steger, Martin Boeker, Michael Steger, Julian Ganter, Tobias Hack, Klemens Baldas, Paul Marc Biever, Daniel Schmitz, Hans Jörg Busch, Michael Patrick Müller, Georg Trummer, Bonaventura Schmid

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background: The city of Freiburg has been among the most affected regions by the COVID-19 pandemic in Germany. In out of hospital cardiac arrest (OHCA) care, all parts of the rescue system were exposed to profound infrastructural changes. We aimed to provide a comprehensive overview of these changes in the resuscitation landscape in the Freiburg region. Methods: Utstein-style quantitative data on OHCA with CPR initiated, occurring in the first pandemic wave between February 27th, 2020 and April 30th, 2020 were compared to the same time periods between 2016 and 2019. Additionally, qualitative changes in the entire rescue system were analyzed and described. Results: Incidence of OHCA with attempted CPR did not significantly increase during the pandemic period (11.1/100.000 inhabitants/63 days vs 10.4/100.000 inhabitants/63 days, p = 1.000). In witnessed cases, bystander-CPR decreased significantly from 57.7% (30/52) to 25% (4/16) (p = 0.043). A severe pre-existing condition (PEC) was documented more often, 66.7% (16/24) vs 38.2% (39/102) there were longer emergency medical services (EMS) response times, more resuscitation attempts terminated on scene, 62.5% (15/24) vs. 34.3% (35/102) and less patients transported to hospital (p = 0.019). Public basic life support courses, an app-based first-responder alarm system, Kids Save Lives activities and a prehospital extracorporeal CPR (eCPR) service were paused during the peak of the pandemic. Conclusion: In our region, bystander CPR in witnessed OHCA cases as well as the number of patients transported to hospital significantly decreased during the first pandemic wave. Several important parts of the resuscitation landscape were paused. The COVID-19 pandemic impedes OHCA care, which leads to additional casualties. Countermeasures should be taken.

Original languageEnglish
Article number85
JournalBMC Emergency Medicine
Volume22
Issue number1
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • Bystander CPR
  • COVID-19
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Chain of survival
  • SARS-CoV-2

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