The impact of the COVID-19 pandemic on the second link of the chain of survival in out-of-hospital cardiac arrest

Abstract

Introduction: Sudden cardiac arrest (SCA) represents an unexpected and abrupt cessation of circulation. The chain of survival refers to the interventions that need to be implemented to increase the survival rate of SCA. Objective: To determine if there are significant deviations in the application of BLS by the eyewitnesses before, during and after the pandemic and if there are differences in achieving ROSC. Material and methods: The study is retrospective and observational. It was conducted for three years at the Institute for Emergency Medical Assistance Novi Sad (IEMANS). The study included patients in whom the ambulance teams implemented measures of Advanced life support (ALS) for out-of-hospital cardiac arrest (OHCA). Patients are divided into three groups based on the year they experienced SCA. Results: There were 580 patients enrolled in the study. The highest number of patients experienced SCA during the pandemic 223 (38,45%). The percentage of immediately initiated resuscitation measures is the lowest during pandemic 35 (15,7%). The arrival time of the ambulance teams is the longest in pandemic group (7,61 ± 3,72). The highest percentage of ROSC was in the prepandemic group that experienced SCA 38 (19,79%) and the lowest during the pandemic 23 (10,31%). Immediately initiated resuscitation measures and the speed of the ambulance team's arrival have the greatest impact on achieving ROSC in OHCA. Conclusion: During the pandemy of COVID-19 the number of out-of-hospital cardiac arrests increased significantly but the survival rate is the lowest in that group. In that group there is the lowest percentage of immediately started measures of BLS and the longest arrival time of the IEMANS team, which has a statistically significant impact on the establishment of ROSC.