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

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.

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