Abstract

Background: The frequency of EMS runs, resuscitation attempts, & out of hospital cardiac arrest survival within a pandemic period has not been studied within the Detroit and metro Detroit region in Michigan. To analyze and study the consequences associated with the spread of COVID-19 within two Michigan counties, a retrospective review from two different medical control authorities (MCA) was completed. We hypothesized the number of out of hospital cardiac arrests and EMS runs to increase during the COVID-19 pandemic, while resuscitation attempts to decrease. Methods: This is a retrospective review study. Records from two MCAs, the Detroit East Medical Control Authority (DEMCA) and the Macomb County Medical Control Authority (MCMCA), were utilized and data was extracted and extrapolated. Each of these MCAs oversee Emergency Medical Services (EMS) within their respective counties. DEMCA provides coverage for the eastern region of Wayne County and MCMCA serves all of Macomb County. Runs, dead-on-scene numbers, & resuscitation attempts were each assessed from March through May of 2019 & 2020. Results: There were nearly double the number of EMS runs for out of hospital cardiac arrest during the 3 main months of the pandemic. In March through May 2020 there were 1756 runs with a mean age of 62.7 years vs. 988 runs during the same period in 2020 with a higher mean age of 65.1 years (p<0.01). This difference was most pronounced in April, which was the height of the pandemic in Michigan (782 vs. 312). The higher number of EMS runs was also more pronounced in Wayne county (1.86 times 2019 numbers) compared to Macomb County (1.65 times 2019 numbers). Resuscitation was attempted on 566 (32.2%) during the pandemic compared to 222 (22.5%) during the same period in the prior year (OR 0.61, 95% CI 0.51 - 0.73, p<0.01). The proportion of patients transferred from the field to an ED did not change significantly (2.6% in the control period vs. 2.1% during the pandemic, p=0.325). Conclusion: There was a 1.78 fold rise in out of hospital cardiac arrest EMS runs during the peak months of the pandemic in metro Detroit compared to the same period in 2019. Despite national concerns on the safety of resuscitation with Covid-19, a higher proportion of patients had resuscitation attempted during the pandemic.

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