Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, United States.
Am J Emerg Med. 2021 Sep;47:192-197. doi: 10.1016/j.ajem.2021.04.033. Epub 2021 Apr 20.
Out-of-hospital cardiac arrest (OHCA) accounts for a substantial proportion of sudden cardiac events globally, with hundreds of thousands of cases reported annually in the United States. The mortality rate of patients who suffer OHCA remains high despite extensive utilization of resources.
We aim to describe the current landscape of OHCA during the COVID-19 pandemic and provide an overview of the logistical challenges and resuscitation protocols amongst emergency medical service (EMS) personnel.
Recent studies in Italy, New York City, and France characterized a significant increase in OHCA incidence in conjunction with the arrival of the 2019 coronavirus disease (COVID-19) pandemic. The presence of the pandemic challenged existing protocols for field resuscitation of cardiac arrest patients as the pandemic necessitated prioritization of EMS personnel and other healthcare providers' safety through stringent personal protective equipment (PPE) requirements. Studies also characterized difficulties encountered by the first responder system during COVID-19, such as dispatcher overload, increased response times, and adherence to PPE requirements, superimposed on PPE shortages. The lack of guidance by governmental agencies and specialty organizations to provide unified safety protocols for resuscitation led to the development of different resuscitative protocols globally.
The ongoing COVID-19 pandemic modified the approach of first responders to OHCA. With the rise in OCHA during the pandemic in several geographic regions and the risks of disease transmission with superimposed equipment shortages, novel noninvasive, adjunct tools, such as point of care ultrasound, warrant consideration. Further prehospital studies should be considered to optimize OHCA and resource management while minimizing risk to personnel.
院外心脏骤停（OHCA）在全球范围内占突发心脏事件的很大比例，美国每年报告数十万例。尽管广泛利用资源，但 OHCA 患者的死亡率仍然很高。
我们旨在描述 COVID-19 大流行期间 OHCA 的现状，并概述紧急医疗服务（EMS）人员在后勤挑战和复苏方案方面的情况。
最近在意大利、纽约市和法国的研究表明，随着 2019 年冠状病毒病（COVID-19）大流行的到来，OHCA 的发病率显著增加。大流行的出现挑战了现有的心脏骤停患者现场复苏方案，因为大流行需要通过严格的个人防护设备（PPE）要求优先考虑 EMS 人员和其他医疗保健提供者的安全。研究还描述了 COVID-19 期间第一反应系统遇到的困难，例如调度员过载、响应时间延长以及对 PPE 要求的遵守，这些都加剧了 PPE 短缺的问题。政府机构和专业组织缺乏提供统一复苏安全协议的指导，导致全球制定了不同的复苏方案。
持续的 COVID-19 大流行改变了急救人员对 OHCA 的处理方式。在多个地理区域，OCHA 在大流行期间增加，加上设备短缺带来的疾病传播风险，新型非侵入性、辅助工具，如即时护理超声，值得考虑。应进一步考虑进行院前研究，以优化 OHCA 和资源管理，同时将人员风险降至最低。
