Impact of the COVID-19 outbreak on emergency medical system missions and emergency department visits in the Venice area

Stella, Federica; Alexopoulos, Chiara; Scquizzato, Tommaso; Zorzi, Alessandro

doi:10.1097/mej.0000000000000724

Cited by 29 publications

(24 citation statements)

References 8 publications

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“…In Northern Italy, the culprit intervals were the time needed for call taking, dispatching, and departure. 9 These delays can be explained respectively by the need to ask questions about COVID-19 status (tested positive or COVID-like symptoms), the increased dispatchers’ workload due to increased volume of calls received, 4 , 16 and wearing personal protective equipment (PPE). Interestingly, the time between departure and arrival was significantly lower, 9 likely due to road traffic reduction during the lockdown.…”

Section: Discussionmentioning

confidence: 99%

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Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review

et al. 2020

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Introduction In addition to the directly attributed mortality, COVID-19 is also likely to increase mortality indirectly. In this systematic review, we investigate the direct and indirect effects of COVID-19 on out-of-hospital cardiac arrests. Methods We searched PubMed, BioMedCentral, Embase and the Cochrane Central Register of Controlled Trials for studies comparing out-of-hospital cardiac arrests occurring during the pandemic and a non-pandemic period. Risk of bias was assessed with the ROBINS-I tool. The primary endpoint was return of spontaneous circulation. Secondary endpoints were bystander-initiated cardiopulmonary resuscitation, survival to hospital discharge, and survival with favourable neurological outcome. Results We identified six studies. In two studies, rates of return of spontaneous circulation and survival to hospital discharge decreased significantly during the pandemic. Especially in Europe, bystander-witnessed cases, bystander-initiated cardiopulmonary resuscitation and resuscitation attempted by emergency medical services were reduced during the pandemic. Also, ambulance response times were significantly delayed across all studies and patients presenting with non-shockable rhythms increased in two studies. In 2020, 3.9-5.9% of tested patients were SARS-CoV-2 positive and 4.8-26% had suggestive symptoms (fever and cough or dyspnoea). Conclusions Out-of-hospital cardiac arrests had worse short-term outcomes during the pandemic than a non-pandemic period suggesting direct effects of COVID-19 infection and indirect effects from lockdown and disruption of healthcare systems. Patients at high risk of deterioration should be identified outside the hospital to promptly initiate treatment and reduce fatalities. Study registration PROSPERO CRD42020195794.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, lockdown and the fear of contracting the infection in hospitals could have prevented patients from calling emergency medical services (EMS) or presenting to emergency departments. 4 …”

Section: Introductionmentioning

confidence: 99%

Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review

et al. 2020

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“… 18 In Venice, Italy, where a nationwide lockdown strategy was implemented to prevent the spread of COVID-19, the number of patients visiting the ED decreased by 50%, and the rate of major trauma decreased due to lockdown. 19 In Osaka, Japan, the number of patients visiting the ED also decreased, and the proportion of patients facing difficulty in hospital acceptance increased. 3 Our study is meaningful because it is based on the NEDIS, which is highly reliable as it is mandatory for all emergency medical institutions to participate in it.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Impact of the Coronavirus Disease Epidemic on the Emergency Medical System in South Korea Using the Korean Triage and Acuity Scale

Kim

Park

et al. 2021

Yonsei Med J

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Purpose Severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19), has spread worldwide. Global health systems, including emergency medical systems, are suffering from a lack of medical resources. Using a method for classifying patients visiting the emergency department (ED), we aimed to investigate trends in emergency medical system usage during the COVID-19 epidemic in Korea. Materials and Methods This retrospective observational study included patients who visited emergency medical institutions registered with the National Emergency Department Information System database from January 1, 2017 to May 31, 2020. The primary outcome was identification of changes in the distribution of patients visiting the ED according to the type of emergency medical institution. The secondary outcome was a detailed comparison of Korean Triage and Acuity Scale (KTAS) levels and patient distributions before and during the infectious disaster crisis period. Results Severe patients visited regional emergency centers (RECs) and local emergency centers (LECs) more frequently during the COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more common in RECs and LECs during the COVID-19 period [RECs, before COVID-19: 300686 (6.3%), during COVID-19: 33548 (8.0%) ( p <0.001); LECs, before COVID-19: 373593 (3.7%), during COVID-19: 38873 (4.5%) ( p <0.001)]. Conclusion During the COVID-19 period, severe patients were shifted to advanced emergency medical institutions, and the KTAS better reflected severe patients. Patient distribution according to the stage of emergency medical institution improved, and validation of the KTAS triage increased more in RECs.

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“…A previous study in Venice, northern Italy, comparing the number of ambulance dispatches in 2019 and 2020 found that the COVID-19 pandemic reduced the number of ambulance dispatches in 2020. [14] It was also reported that the number of emergency department visits decreased during the severe acute respiratory syndrome (SARS) pandemic that spread in 2003. [15][16][17][18][19] Thus, when an infectious disease spreads throughout a city or society, the number of emergency department visits may decrease as a result of people buying medicines from pharmacies for their own care and refraining from visiting the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Incidence and mortality of patients transported by ambulance during the first surge of the COVID-19 pandemic in Osaka Prefecture, Japan

Katayama

Tanaka

Kitamura

et al. 2021

Preprint

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Background; Novel corona virus (COVID-19) outbreaks have spread worldwide. Although the COVID-19 pandemic affects the emergency medical service (EMS) system, which is one factor of primary care, little is known about its impact. This study aimed to reveal the impact of the COVID-19 pandemic on the EMS system and outcome of patients transported by ambulance.Methods; This was a retrospective study with a study period from 1 January 2020 to 31 May 2020. We included patients transported by ambulance who were registered in a population-based registry of patients transported by ambulance. The endpoints of this study were the incident number of patients transported by ambulance each month and the number of deaths among these patients admitted to hospital each month. We calculated the incidence rate ratio (IRR) and 95% confidence interval (CI) using a Poisson regression model with year 2019 as the reference.Results; From January to May 2019, 205,195 patients were transported, whereas from January to May 2020, 180,362 patients were transported, indicating a significant decrease in the number of emergency patients transported by ambulance (IRR: 0.88, 95% CI: 0.87–0.88). The number of deaths among emergency patients admitted to hospital was 5237 in January-May 2019 and remained unchanged at 5172 in January-May 2020 (IRR: 0.99, 95% CI: 0.95–1.03).Conclusion; The first surge of the COVID-19 pandemic had no adverse effect on the EMS system in Osaka Prefecture, Japan.

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Impact of the COVID-19 outbreak on emergency medical system missions and emergency department visits in the Venice area

Cited by 29 publications

References 8 publications

Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review

Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review

Analysis of the Impact of the Coronavirus Disease Epidemic on the Emergency Medical System in South Korea Using the Korean Triage and Acuity Scale

Incidence and mortality of patients transported by ambulance during the first surge of the COVID-19 pandemic in Osaka Prefecture, Japan

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