References

Baldi E, Sechi GM, Mare C COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J. 2020; 41:(32)3045-3054 https://doi.org/10.1093/eurheartj/ehaa508

Bossaert LL, Perkins GD, Askitopoulou H European Resuscitation Council guidelines for resuscitation 2015: section 11. The ethics of resuscitation and end-of-life decisions. Resuscitation. 2015; 95:302-311 https://doi.org/10.1016/j.resuscitation.2015.07.033

Chan PS, Girotra S, Tang Y, Al-Araji R, Nallamothu BK, McNally B. Outcomes for out-of-hospital cardiac arrest in the United States during the coronavirus disease 2019 pandemic. JAMA Cardiol. 2021; 6:(3)296-303 https://doi.org/10.1001/jamacardio.2020.6210

De Filippo O, D'Ascenzo F, Angelini F Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N Engl J Med. 2020; 383:(1)88-89 https://doi.org/10.1056/NEJMc2009166

Esakandari H, Nabi-Afjadi M, Fakkari-Afjadi J, Farahmandian N, Miresmaeili SM, Bahreini E. A comprehensive review of COVID-19 characteristics. Biol Proced Online. 2020; 22 https://doi.org/10.1186/s12575-020-00128-2

Fothergill RT, Smith AL, Wrigley F, Perkins GD. Out-of-hospital cardiac arrest in London during the COVID-19 pandemic. Resusc Plus. 2021; 5 https://doi.org/10.1016/j.resplu.2020.100066

Institute for Government. Timeline of UK coronavirus lockdowns, March 2020 to March 2021. 2021. https://tinyurl.com/2s4enaj6 (accessed 13 March 2022)

Mafham MM, Spata E, Goldacre R COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020; 396:(10248)381-389 https://doi.org/10.1016/S0140-6736(20)31356-8

Marijon E, Karam N, Jost D Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. Lancet Public Health. 2020; 5:(8)e437-e443 https://doi.org/10.1016/S2468-2667(20)30117-1

NHS. Symptoms of coronavirus (COVID-19). 2021. https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/ (accessed 13 March 2022)

Office for National Statistics. Leading causes of death, UK: 2001–2018. 2020. https://tinyurl.com/zzdv98x3 (accessed 13 March 2022)

Resuscitation Council UK. Resuscitation guidelines 2021. 2021. https://www.resus.org.uk/library/2021-resuscitation-guidelines (accessed 16 March 2022)

Royal College of Emergency Medicine. CORE (level 1) ultrasound curriculum. 2010. https://rcem.ac.uk/wp-content/uploads/2021/10/1.14.5-RCEM-EMUS-booklet-3.pdf (accessed 26 March 2022)

Samidurai A, Das A. Cardiovascular complications associated with COVID-19 and potential therapeutic strategies. Int J Mol Sci. 2020; 21:(18) https://doi.org/10.3390/ijms21186790

Scquizzato T, Landoni G, Paoli A Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: a systematic review. Resuscitation. 2020; 157:241-247 https://doi.org/10.1016/j.resuscitation.2020.10.020

Sultanian P, Lundgren P, Strömsöe A Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation. Eur Heart J. 2021; 42:(11)1094-1106 https://doi.org/10.1093/eurheartj/ehaa1067

COVID-19 pandemic supplementary procedures (2) cardiac arrest & ROSC management [withdrawn]. V2.0. 2020;

Thames Valley Air Ambulance. Called out to over 2,500 missions last year. News story. 2021. https://tinyurl.com/5yz9vbnt (accessed 13 March 2022)

UK Government. Prime minister's statement on coronavirus (COVID-19): 23 March 2020. 2020. https://tinyurl.com/pw2npk46 (accessed 13 March 2022)

UK Government. Coronavirus (COVID-19) in the UK. 2021a. https://coronavirus.data.gov.uk/details/cases (accessed 26 March 2022)

UK Government. Infection prevention and control for seasonal respiratory infections in health and care settings (including SARS-CoV-2) for winter 2021 to 2022—appendix for UK ambulance services. 2021b. https://www.gov.uk/government/publications/covid-19-guidance-for-ambulance-trusts/covid-19-guidance-for-ambulance-trusts (accessed 13 March 2022)

World Health Organization. Rolling updates on coronavirus disease (COVID-19). 2020a. https://tinyurl.com/mr2zetk6 (accessed 13 March 2022)

World Health Organization. WHO director-general's opening remarks at the media briefing on COVID-19—11 March 2020. 2020b. https://tinyurl.com/mtk3raef (accessed 13 March 2022)

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