Out-of-Hospital Spanish Cardiac Arrest Registry (OHSCAR). Results of the first year

Ortiz, Fernando Rosell; Roig, Francesc Escalada; Pascual, José María Navalpotro; Vázquez, José Antonio; Echarri-Sucunza, Alfredo; Torres, Juan Antonio Cordero; Cobos, Elisa; Valle, Marta Martínez del; Rozalen, I. Ceniceros; Sánchez, Enrique Martín; Ruiz, María Victoria Mier; Berlanga, Raúl Canabal; Cabeza, Nuria López; Olalde, Karlos Ibarguren; Ruiz, Basilio Teja; García-Ochoa, María José; López-Navarro, Rafael Zoyo; Adsuar, José Manuel; Cortes, José A.; Valle, Patricia Fernández del

doi:10.1016/j.resuscitation.2015.09.238

Cited by 9 publications

(12 citation statements)

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“…This review resulted in 14 publications. 1,[13][14][15][16][17][18][19][20][21][22][23][24][25] The total list of publications collected during this second stage extended beyond 200 publications. Some were relevant as a general orientation on the subject or for use during discussions with participants (eg, regarding the risk of children being infected and the efficacy, safety, and education of the several ventilation techniques).…”

Section: Methodsmentioning

confidence: 99%

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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Section: Methodsmentioning

confidence: 99%

Resuscitation of Drowned Persons During the COVID-19 Pandemic

et al. 2022

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“…Although increased incidence is found in some regions overall in population-based observational studies, [6][7][8][9] other population-based registries do not reveal substantial changes, 10,11 with some publications even reporting a decrease in the number of recorded patients with OHCAs with resuscitation attempts from out-of-hospital emergency medical services (EMS). 12 Agreement does exist regarding the substantial decrease in some of the key actions in the chain of survival, such as bystander defibrillation, 5,12,13 with even clearer outcomes pertaining to resuscitation attempts. A marked decline has been reported in the percentage of patients with return of spontaneous circulation (ROSC) at hospital arrival and those surviving to hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

“…A marked decline has been reported in the percentage of patients with return of spontaneous circulation (ROSC) at hospital arrival and those surviving to hospital discharge. [6][7][8][9][10][11][12][13][14] This being said, these negative outcomes were found to be independent of local pandemic incidence. 10,12 The disappearance of such outcomes would provide evidence that normal functioning of health care services has resumed; however, no data are yet available to support this.…”

Section: Introductionmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Following the COVID-19 Pandemic

Ruiz Azpiazu,

Fernández del Valle,

Echarri Sucunza

et al. 2024

JAMA Netw Open

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ImportanceOut-of-hospital cardiac arrest (OHCA) health care provision may be a good indicator of the recovery of the health care system involved in OHCA care following the COVID-19 pandemic. There is a lack of data regarding outcomes capable of verifying this recovery.ObjectiveTo determine whether return to spontaneous circulation, overall survival, and survival with good neurological outcome increased in patients with OHCA since the COVID-19 pandemic was brought under control in 2022 compared with prepandemic and pandemic levels.Design, Setting, and ParticipantsThis observational cohort study was conducted to examine health care response and survival with good neurological outcome at hospital discharge in patients treated following OHCA. A 3-month period, including the first wave of the pandemic (February 1 to April 30, 2020), was compared with 2 periods before (April 1, 2017, to March 31, 2018) and after (January 1 to December 31, 2022) the pandemic. Data analysis was performed in July 2023. Emergency medical services (EMS) serving a population of more than 28 million inhabitants across 10 Spanish regions participated. Patients with OHCA were included if participating EMS initiated resuscitation or continued resuscitation initiated by a first responder.ExposureThe pandemic was considered to be under control following the official declaration that infection with SARS-CoV-2 was to be considered another acute respiratory infection.Main Outcome and MeasuresThe main outcomes were return of spontaneous circulation, overall survival, and survival at hospital discharge with good neurological outcome, expressed as unimpaired or minimally impaired cerebral performance.ResultsA total of 14 732 patients (mean [SD] age, 64.2 [17.2] years; 10 451 [71.2%] male) were included, with 6372 OHCAs occurring during the prepandemic period, 1409 OHCAs during the pandemic period, and 6951 OHCAs during the postpandemic period. There was a higher incidence of OHCAs with a resuscitation attempt in the postpandemic period compared with the pandemic period (rate ratio, 4.93; 95% CI, 4.66-5.22; P &lt; .001), with lower incidence of futile resuscitation for OHCAs (2.1 per 100 000 person-years vs 1.3 per 100 000 person-years; rate ratio, 0.81; 95% CI, 0.71-0.92; P &lt; .001). Recovery of spontaneous circulation at hospital admission increased from 20.5% in the pandemic period to 30.5% in the postpandemic period (relative risk [RR], 1.08; 95% CI, 1.06-1.10; P &lt; .001). In the same way, overall survival at discharge increased from 7.6% to 11.2% (RR, 1.45; 95% CI, 1.21-1.75; P &lt; .001), with 6.6% of patients being discharged with good neurological status (Cerebral Performance Category Scale categories 1-2) in the pandemic period compared with 9.6% of patients in the postpandemic period (RR, 1.07; 95% CI, 1.04-1.10; P &lt; .001).Conclusions and RelevanceIn this cohort study, survival with good neurological outcome at hospital discharge following OHCA increased significantly after the COVID-19 pandemic.

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“…In Spain, 57.5% of cardiorespiratory arrests occur outside the hospital setting, so on many occasions the environmental circumstances in which the initial CPR is carried out will not be controlled [13].…”

Section: Introductionmentioning

confidence: 99%

Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions

Conty

Polonio-López

Maestre-Miquel

et al. 2020

IJERPH

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Background: To determine the relationship between physiological fatigue and the quality of cardiopulmonary resuscitation (CPR) in trained resuscitators in hostile thermal environments (extreme cold and heat) simulating the different conditions found in an out-of-hospital cardiorespiratory arrest. Methods: Prospective observational study involving 60 students of the health sciences with training in resuscitation, who simulated CPR on a mannequin for 10 min in different thermal environments: thermo-neutral environment (21 °C and 60% humidity), heat environment (41 °C and 98% humidity) and cold environment (−35 °C and 80% humidity). Physiological parameters (heart rate and lactic acid) and CPR quality were monitored. Results: We detected a significant increase in the number of compressions per minute in the “heat environment” group after three minutes and in the mean rate after one minute. We observed a negative correlation between the total number of compressions and mean rate with respect to mean depth. The fraction of compressions (proportion of time in which chest compressions are carried out) was significant over time and the mean rate was higher in the “heat environment”. Physiological parameters revealed no differences in heart rate depending on the resuscitation scenario; however, there was a greater and faster increase in lactate in the “heat environment” (significant at minute 3). The total proportion of participants reaching metabolic fatigue was also higher in the “heat environment”. Conclusions: A warm climate modifies metabolic parameters, reducing the quality of the CPR maneuver.

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Out-of-Hospital Spanish Cardiac Arrest Registry (OHSCAR). Results of the first year

Cited by 9 publications

References 0 publications

Resuscitation of Drowned Persons During the COVID-19 Pandemic

Resuscitation of Drowned Persons During the COVID-19 Pandemic

Out-of-Hospital Cardiac Arrest Following the COVID-19 Pandemic

Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions

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