Abstract 226: Statewide Out-of-hospital Cardiac Arrest During the Covid-19 Pandemic

Abstract

Introduction: Little is known about statewide out-of-hospital cardiac arrests (OOHCA) during a global pandemic. Objective: To characterize the impact of the COVID-19 pandemic on state OOHCA rates. Methods: Data for non-traumatic, OOHCA were obtained and analyzed from a statewide EMS information system from March 1, 2000 to May 31, 2020 (pandemic) and compared to data obtained from the same 3-month period the prior year (control). Analysis occurred using a web-based application designed to analyze state EMS data. OOHCA were identified using a validated data filter applied to 911 calls and limited to transporting EMS units. Shockable OOHCA and arrests occurring in 5 counties with the highest number of COVID-19 deaths during the pandemic were also analyzed. Results: There were 4,665 OOHCAs identified during the pandemic compared to 3,261 OOHCA during the control period, a 43.1% increase (p<0.00001). Bystander AED use (10% vs 10%), bystander CPR (38% vs. 38%), and bystander witnessed arrests (34% and 33%) were similar. Rates of EMS termination of resuscitation (TOR) were higher (59% vs. 47%), while endotracheal intubation (ETI) (12% vs. 31%), and ROSC (5% vs. 8%) were lower during the COVID-19 period. Blacks had a higher rate of OOHCA during the pandemic period (26.6% vs 18.6%, p<0.00001). Overall shockable OOHCA increased by 14.8% (403 vs. 351, p=0.002) during the pandemic. Bystander AED use (10% vs 11%), bystander CPR (55% vs. 51%), and bystander witnessed (71% and 71%) were similar. Rates of field TOR were 33% vs. 24%, ETI were 14% vs. 31%, and ROSC were 16% vs. 17%. Within the 5 highest impact counties total OOHCA increased by 61.4% (2,702 vs. 1,674, p<0.00001) and shockable OOHCAs increased by 21.4% (207 vs 170, p=0.004). Conclusions: OOHCA and shockable OOHCA increased during the COVID-19 pandemic statewide and to a higher degree in the 5 high impact counties. Little change was noted in rates of bystander AED use, CPR, and witnessed arrests. EMS TOR rates increased while ETI rates decreased. ROSC rates decreased in the overall OOHCA group but were not significantly changed in shockable OOHCA. OOHCA involving the black race occurred more frequently. Further research is warranted to understand the causes of these observations.