Assessment of changes in cardiopulmonary resuscitation practices and outcomes on 1005 victims of out-of-hospital cardiac arrest during the COVID-19 outbreak: registry-based study

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Abstract

Background

The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA).

Methods

OHCA of medical origins identified from the French National Cardiac Arrest Registry between March 1st and April 31st 2020 (COVID-19 period), were analysed. Different resuscitation characteristics were compared with the same period from the previous year (non-COVID-19 period).

Results

Overall, 1005 OHCA during the COVID-19 period and 1620 during the non-COVID-19 period were compared. During the COVID-19 period, bystanders and first aid providers initiated CPR less frequently (49.8% versus 54.9%; difference, − 5.1 percentage points [95% CI, − 9.1 to − 1.2]; and 84.3% vs. 88.7%; difference, − 4.4 percentage points [95% CI, − 7.1 to − 1.6]; respectively) as did mobile medical teams (67.3% vs. 75.0%; difference, − 7.7 percentage points [95% CI, − 11.3 to − 4.1]). First aid providers used defibrillators less often (66.0% vs. 74.1%; difference, − 8.2 percentage points [95% CI, − 11.8 to − 4.6]). Return of spontaneous circulation (ROSC) and D30 survival were lower during the COVID-19 period (19.5% vs. 25.3%; difference, − 5.8 percentage points [95% CI, − 9.0 to − 2.5]; and 2.8% vs. 6.4%; difference, − 3.6 percentage points [95% CI, − 5.2 to − 1.9]; respectively).

Conclusions

During the COVID-19 period, we observed a decrease in CPR initiation regardless of whether patients were suspected of SARS-CoV-2 infection or not. In the current atmosphere, it is important to communicate good resuscitation practices to avoid drastic and lasting reductions in survival rates after an OHCA.

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Author and article information

Contributors

François Javaudin:

ORCID: https://orcid.org/0000-0002-7728-2320

francois.javaudin@chu-nantes.fr

Journal

Journal ID (nlm-ta): Scand J Trauma Resusc Emerg Med

Journal ID (iso-abbrev): Scand J Trauma Resusc Emerg Med

Title: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1757-7241

Publication date (Electronic): 18 December 2020

Publication date PMC-release: 18 December 2020

Publication date Collection: 2020

Volume: 28

Electronic Location Identifier: 119

Affiliations

[1 ]Univ. Lille, CHU Lille, ULR 2694 – METRICS, Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France

[2 ]French national out-of-hospital cardiac arrest registry, Registre électronique des Arrêts Cardiaques, Lille, France

[3 ]GRID grid.410527.5, ISNI 0000 0004 1765 1301, Université de Lorraine, Inserm U1116; F-CRIN INI-CRCT, Emergency Department, , University Hospital of Nancy, ; Nancy, France

[4 ]GRID grid.31151.37, Medical ICU, , University Hospital Center, ; Nantes, France

[5 ]GRID grid.462416.3, ISNI 0000 0004 0495 1460, the Paris Cardiovascular Research Center, INSERM Unité 970 & the AfterROSC Network, ; Paris, France

[6 ]GRID grid.410529.b, ISNI 0000 0001 0792 4829, Grenoble University Hospital, ; Grenoble, France

[7 ]GRID grid.277151.7, ISNI 0000 0004 0472 0371, Department of Emergency Medicine, , University Hospital of Nantes, ; Nantes, France

[8 ]GRID grid.4817.a, University of Nantes, Microbiotas Hosts Antibiotics and bacterial Resistances (MiHAR), , University of Nantes, ; Nantes, France

Author information

François Javaudin https://orcid.org/0000-0002-7728-2320

Article

Publisher ID: 813

DOI: 10.1186/s13049-020-00813-x

PMC ID: 7747186

PubMed ID: 33339538

SO-VID: 82609335-d31d-43c3-8179-480a17d4e1cc

License:

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