Characteristics of Emergency Medical Service Missions in Out-of-Hospital Cardiac Arrest and Death Cases in the Periods of Before and After the COVID-19 Pandemic

Abstract

Background: Some studies in countries affected by the coronavirus disease of 2019 (COVID-19) pandemic have shown that the missions of Emergency Medical Service (EMS) have changed during the COVID-19 pandemic, and the rate of death and out-of-hospital cardiac arrest (OHCA) has been increased due to the direct and indirect effects of COVID-19. Objective: The aim of this study was to determine the effect of the COVID-19 pandemic on the process of EMS missions, death, and OHCA. Methods: This cross-sectional study was performed in Tehran, Iran. All conducted missions in the first six months of the three consecutive solar years of March 21 until September 22 of 2018-2020, which were registered in the registry bank of the Tehran EMS center, were assessed and compared. Based on the opinion of experts, the technician’s on-scene diagnoses were categorized into 14 groups, and then death and OHCA cases were compared. Results: In this study, the data of 1,050,376 missions performed in three study periods were analyzed. In general, the number of missions in 2020 was 17.83% fewer than that of 2019 (P < .001); however, the number of missions in 2019 was 30.33% more than that of 2018. On the other hand, the missions of respiratory problems, cardiopulmonary arrest, infectious diseases, and poisoning were increased in 2020 compared to that of 2019. The raw number of OHCA and death cases respectively in 2018, 2019, and 2020 were 25.0, 22.7, and 28.6 cases per 1,000 missions. Of all patients who died in 2020, 4.9% were probable/confirmed COVID-19 cases. The history of heart disease, hypertension, diabetes, and respiratory disease in patients in 2020 was more frequent than that of the other two years. Conclusion: This study showed that the number of missions in the Tehran EMS in 2020 were decreased compared to that of 2019, however the number of missions in 2019 was more than that of 2018. Respiratory problems, infectious diseases, poisoning, death, and OHCA were increased compared to the previous two years and cardiovascular complaints, neurological problems, and motor vehicle collisions (MVCs) in 2020 were fewer than that of the other two years

Lasting Effects of COVID-19 Pandemic on Prehospital Emergency Medical Service Missions

“…7 Similar studies from Italy, Iran, Finland and the USA on the influence of the SARS-CoV-2 pandemic on emergency medical services confirmed our described decline in total mission numbers, with rates from 5.7% to 23%. 5,6,8,9 In accordance with our results, another German study that investigated the area of Bavaria found the most substantial decrease of mission numbers during the first lockdown period. 10 The reasons for the drop in mission numbers are multifaceted: reaching from a change in lifestyle habits that led to a lowered risk of accidents, to the avoidance of reaching for health services because of the fear of facing an infectious disease or getting infected in the emergency department or hospitals, and to worry and ambitions not to overload the health system.…”

“…[1][2][3][4] During the pandemic spread of COVID-19, the utilization of prehospital emergency health services (PHEMS) decreased substantially during the lockdown periods all over the world. [5][6][7][8][9][10] PHEMS are essential to the functionality of health systems. The challenging conditions of the COVID-19 pandemic, including special requirements for personal protective equipment (PPE) and patient transport, have put PHEMS under immense pressure to adapt.…”

Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review

“… Structural/ Systemic 73 Hasani-Sharamin et. al 85 Characteristics of Emergency Medical Service Missions in Out-of-Hospital Cardiac Arrest and Death Cases in the Periods of Before and After the COVID-19 Pandemic Cross-sectional Mission data Tehran, IR ● The number of OOHCAs in 2019 was greater than that of 2018 or 2020. ● Respiratory distress and infection were more common in 2020 than 2019.…”

External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score

“…Up to a quarter of the urban EMS missions are related to OHCA, 18 and the achievement of ROSC represents the first step in the care process for these patients. Moreover, ROSC could be considered a quality indicator for the EMS taking into account both organizational and technical aspects of the delivered resuscitation.…”