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air ambulance
patient care
OHCA
evidence

Air ambulance outcomes of out-of-hospital cardiac arrest seen in the pandemic

02 April 2022
Features
02 April 2022
Volume 14 · Issue 4

Abstract

Introduction:

COVID-19 was declared a global health pandemic in March 2020, and national lockdowns were imposed in an attempt to limit the spread of the virus. Several studies have reported significant increases in the number of out-of-hospital cardiac arrest (OHCA) attendances coupled with a reduction in return of spontaneous circulation (ROSC). This is the first study to report the characteristics and outcomes from OHCA in a UK air ambulance setting.

Methods:

A retrospective database review of adult OHCA with a medical cause attended by Thames Valley Air Ambulance was undertaken covering two time periods: 1 February 2019 to 31 January 2020; and 1 February 2020 to 31 January 2021. Cases during the pandemic period were screened for COVID-19 symptoms. Descriptive statistics were used to establish the characteristics of COVID-19. The primary outcome of the study was ROSC on arrival at hospital.

Results:

An overall rise of 6.6% in OHCA was noted between the pre-pandemic and pandemic periods, with a prevalence of COVID-19 of 6.0%. There was a significant increase in termination of resuscitation at scene (42.6% to 54.8%; P<0.001). Overall, ROSC at hospital decreased (37.7% versus 31.1%).

Conclusion:

This study highlights the impact and implications of a global pandemic on OHCA and an air ambulance system. Poorer overall outcomes were observed during the pandemic period. Further exploration of the effects of COVID-19 on OHCA and air ambulance systems is required.

The novel coronavirus pandemic has affected healthcare on an unprecedented global scale. The first cases of SARS-CoV-2 infection (COVID-19) were discovered in the Wuhan area of China (World Health Organization (WHO), 2020a), and the virus spread rapidly across the world, with COVID-19 being declared a pandemic by the World Health Organisation on 11 March 2020 (WHO, 2020b).

The first known cases of COVID-19 in the UK were recorded on 31 January 2020 (UK Government, 2021a). This was followed by a rapid increase in the number of cases between February and March 2020 as the virus spread through the population.

A government-imposed national lockdown came into effect on 23 March 2020, with the population being advised to stay at home and go out for essential reasons only, including grocery shopping, and all non-essential retail was closed (Institute for Government, 2021). Widespread testing for COVID-19 was not initially available in the UK.

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Out-of-hospital cardiac arrest
Air ambulance
COVID-19 pandemic
Prehospital emergency medicine