Cardiac arrest & resuscitation
Impact of the COVID-19 pandemic on Canadian emergency medical system management of out-of-hospital cardiac arrest: A retrospective cohort study
Authors' conclusion
The COVID-19 pandemic was associated with substantial changes in EMS management of OHCA.
Study context
- Population
- Adult, non-traumatic of hospital cardiac arrest (OHCA) treated by emergency medical system (EMS), Canadian Resuscitation Outcome Consortium (CanROC) registry, January 27th, 2018 to December 31st, 2021
- Participants
- 17,488 vs 12,947
- Exposure
- COVID-19 period vs pre-COVID-19 period
- COVID-19n = 17,488
- Pre-COVID-19n = 12,947reference
- Outcome
- EMS management of OHCA, COVID-19 vs pre-COVID-19 period
Methodological detailsinterrupted time series analysis, adjusted regression models
- Interrupted time series analysis
- Adjusted regression models
Main finding
As reported in the abstract
- Cumulative number of defibrillations by EMS reduced
- aRR 0.91, 95% CI 0.89 - 0.93, p < 0.01
- Intubation attempts reduced
- aOR 0.33, 95% CI 0.31 - 0.34, p < 0.01
- Supraglottic airway use higher
- aOR 1.23, 95% CI 1.16-1.30, p < 0.01
- Intravenous access reduced
- aOR for intravenous access 0.84, 95% CI 0.79 - 0.89, p < 0.01
- Intraosseous access reduced
- aOR for intraosseous access 0.89, 95% CI 0.82 - 0.96, p < 0.01
- Epinephrine administration reduced
- aOR 0.89, 95% CI 0.85 - 0.94, p < 0.01
- Resuscitation termination on scene higher
- aOR 1.38, 95% CI 1.31 - 1.46, p < 0.01
- Delay to initiation of chest compressions
- 2 min. vs. 3 min., p < 0.01
- Delay to intubation
- 16 min. vs. 19 min., p = 0.01
- Delay to epinephrine administration
- 11 min. vs. 13 min., p < 0.01
- Supraglottic airways inserted earlier
- 11 min. vs. 10 min., p < 0.01
Observational data: associations, not effects.
Further findings
Time to EMS interventions
- Time to chest compressions: 2 min. vs. 3 min. (delayed during COVID-19)
- P < 0.01
- Time to intubation: 16 min. vs. 19 min. (delayed during COVID-19)
- P = 0.01
- Time to epinephrine: 11 min. vs. 13 min. (delayed during COVID-19)
- P < 0.01
- Time to supraglottic airway: 11 min. vs. 10 min. (earlier during COVID-19)
- P < 0.01
Original publication
Impact of the COVID-19 pandemic on Canadian emergency medical system management of out-of-hospital cardiac arrest: A retrospective cohort study. Resuscitation. Published 20 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →