Out-of-Hospital Cardiac Arrest in London during the COVID-19 pandemic

Fothergill, Rachael; Smith, Adam; Wrigley, F. R. H.; Perkins, Gavin D

doi:10.1016/j.resplu.2020.100066

Cited by 80 publications

(153 citation statements)

References 20 publications

(47 reference statements)

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“…As a result, the illustration creates the appearance that OHCA cases seemed to persist into late April as daily COVID-19 numbers were diminishing. However, as elegantly reported in other publications, the actual daily number of OHCA cases were dramatically escalating at the end of March into early April, and peaking well above the average for the month [7À9, 25,26]. Accordingly, daily numbers declined rapidly as the local COVID-19 prevalence dissipated in both cities [9,25].…”

Section: Discussionsupporting

confidence: 57%

“…This pattern is consistent even within cities only mildly affected by COVID-19 [28]. Those same studies also provided further subgroup analyses emphasizing relative risks according to age, demographics, presenting cardiac rhythm, response intervals and treatment provided [7À10, 25,26,28].…”

Section: Discussionsupporting

confidence: 52%

“…Increases in OHCA were already beginning to evolve with resulting operational impact on the EMS systems in cities that were later identified as epicenters [7À9,26]. The surge in OHCA cases were being observed locally at least a week or two before the large numbers of COVID-19 cases were being formally identified, both in the U.S. and Europe [9,26]. According to current World Health Organization statistics, fewer than 2 deaths were being attributed to COVID-19 in the U.S. by March 3 and less than 5000 as of April 1, 2020.…”

Section: Discussionmentioning

confidence: 99%

“…Other investigators have also indicated that OHCA is directly related to COVID-19 [7À9, 25,26]. By inference, OHCA might be considered one of the myriad of chimeric presenting symptoms of COVID-19 or, more likely, one early-appearing complication of infection.…”

Section: Discussionmentioning

confidence: 99%

“…A third important implication of this study is the observation that these increases in OHCA and the resulting deaths were not counted among COVID-related deaths. As now reported in much greater detail by many of the individual participating cities, not only were there significantly increased numbers of OHCA during the pandemic outbreak, but also larger percentages of OHCA patients were found to be unsalvageable despite intensive resuscitation efforts [7À10, 25,26,28]. The majority of these additional cases were pronounced dead, either on-scene after aggressive resuscitation efforts, or, in some cases, soon after emergency department arrival [7À10, 25,26,28].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19

et al. 2021

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Background: Though variable, many major metropolitan cities reported profound and unprecedented increases in out-of-hospital cardiac arrest (OHCA) in early 2020. This study examined the relative magnitude of those increases and their relationship to COVID-19 prevalence. Methods: EMS (9-1-1 system) medical directors for 50 of the largest U.S. cities agreed to provide the aggregate, de-identified, pre-existing monthly tallies of OHCA among adults (age >18 years) occurring between January and June 2020 within their respective jurisdictions. Identical comparison data were also provided for

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Section: Discussionsupporting

confidence: 57%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19

et al. 2021

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Resuscitation of Drowned Persons During the COVID-19 Pandemic

et al. 2022

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IMPORTANCE Resuscitation is a niche example of how the COVID-19 pandemic has affected society in the long term. Those trained in cardiopulmonary resuscitation (CPR) face the dilemma that attempting to save a life may result in their own harm. This is most of all a problem for drowning, where hypoxia is the cause of cardiac arrest and ventilation is the essential first step in reversing the situation. OBJECTIVETo develop recommendations for water rescue organizations in providing their rescuers with safe drowning resuscitation procedures during the COVID-19 pandemic. EVIDENCE REVIEW Two consecutive modified Delphi procedures involving 56 participants from 17 countries with expertise in drowning prevention research, resuscitation, and programming were performed from March 28, 2020, to March 29, 2021. In parallel, PubMed and Google Scholar were searched to identify new emerging evidence relevant to each core element, acknowledge previous studies relevant in the new context, and identify knowledge gaps. FINDINGS Seven core elements, each with their own specific recommendations, were identified in the initial consensus procedure and were grouped into 4 categories: (1) prevention and mitigation of the risks of becoming infected, (2) resuscitation of drowned persons during the COVID-19 pandemic, (3) organizational responsibilities, and (4) organizations unable to meet the recommended guidelines. The common measures of infection risk mitigation, personal protective equipment, and vaccination are the base of the recommendations. Measures to increase drowning prevention efforts reduce the root cause of the dilemma. Additional infection risk mitigation measures include screening all people entering aquatic facilities, defining criteria for futile resuscitation, and avoiding contact with drowned persons by rescuers with a high-risk profile. Ventilation techniques must balance required skill level, oxygen delivery, infection risk, and costs of equipment and training.Bag-mask ventilation with a high-efficiency particulate air filter by 2 trained rescuers is advised. Major implications for the methods, facilities, and environment of CPR training have been identified, including nonpractical skills to avoid being infected or to infect others. Most of all, the organization is responsible for informing their members about the impact of the COVID-19 pandemic and taking measures that maximize rescuer safety. Research is urgently needed to better understand, develop, and implement strategies to reduce infection transmission during drowning resuscitation. CONCLUSIONS AND RELEVANCEThis consensus document provides an overview of recommendations for water rescue organizations to improve the safety of their rescuers during the COVID-19 pandemic and balances the competing interests between a potentially lifesaving intervention and risk to the rescuer. The consensus-based recommendations can also serve as an example for other volunteer organizations and altruistic laypeople who may provide resuscitation.

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Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

Nishimura

Suga

Ishihara

et al. 2023

Acute Medicine & Surgery

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Aim In the current era of the coronavirus disease 2019 (COVID‐19) pandemic, the responsiveness of emergency medical service (EMS) transport for patients with internal illness is often delayed. However, the influence of the COVID‐19 pandemic on prehospital transport for patients with trauma has not yet been fully elucidated. This study aims to examine the effect of COVID‐19 case surges on EMS transport for patients with trauma during the COVID‐19 states of emergency in Kobe, Japan. Methods EMS data during the states of emergency were compared with those in the 2019 prepandemic period. The incidence of difficulty securing hospital acceptance (four or more calls to medical institutions and ambulance staying at the scene for 30 min or more) was evaluated as a primary outcome. Secondary outcomes were the time spent at the trauma scene and the number of calls requesting hospital acceptance. The time spent at the trauma scene was stratified by trauma severity. Results The incidence of difficulty securing hospital acceptance increased (1.2% versus 3.2%, P < 0.01). Logistic regression analysis revealed that the duration of the states of emergency was associated with difficulty securing hospital acceptance (odds ratio [OR] 2.08, 95% confidence interval 1.77–2.45; P < 0.01). Although the mean time spent at the trauma scene among the less severe, moderately severe, and severe trauma groups was prolonged, the time for the life‐threatening group did not change. The number of request calls increased during the states of emergency. Conclusion Difficulty securing hospital acceptance increased; however, the time spent at the trauma scene did not significantly change for the life‐threatening group.

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Out-of-Hospital Cardiac Arrest in London during the COVID-19 pandemic

Cited by 80 publications

References 20 publications

The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19

The relationship of large city out-of-hospital cardiac arrests and the prevalence of COVID-19

Resuscitation of Drowned Persons During the COVID-19 Pandemic

Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

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