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Assessing the Effect of a Pandemic on Emergency Medical Service Response Times and Interventions for Out-of-Hospital

Atsuo Nakamura1, Masaharu Odo1

  • 1Department of Emergency and Critical Care Medicine, Iizuka City Hospital, Iizuka, JPN.

Cureus
|December 16, 2024
PubMed

Insights

The COVID-19 pandemic caused a 3-minute delay in emergency medical service (EMS) response for out-of-hospital cardiac arrest (OHCA) patients. This disruption impacted prehospital times and clinical interventions, necessitating system improvements for better patient outcomes.

Area of Science:

  • Emergency Medicine
  • Public Health
  • Cardiology

Background:

  • The COVID-19 pandemic significantly disrupted emergency medical services (EMS), particularly for patients experiencing out-of-hospital cardiac arrest (OHCA).
  • Assessing the pandemic's impact on prehospital care, including response times and interventions, is crucial for understanding patient outcomes.

Purpose of the Study:

  • To analyze changes in EMS operations and prehospital times for OHCA patients before and during the COVID-19 pandemic.
  • To evaluate the pandemic's effect on emergency interventions and hospital admission requests for OHCA cases.

Main Methods:

  • Retrospective review of 925 out-of-hospital cardiac arrest cases from January 2017 to December 2022.
  • Categorization into pre-pandemic and pandemic phases to compare prehospital times (call intake to hospital arrival) and procedural frequency.
  • Multivariate analysis to assess changes in prehospital time, hospital admission requests, laryngeal tube insertion, and venous line placement.

Main Results:

  • The pandemic phase showed a 3-minute average increase in prehospital delay for OHCA patients (P < 0.0001).
  • Significant increases were observed in on-scene arrival time (aOR: 2.06), laryngeal tube insertions (aOR: 3.2), and post-transport venous access placements (aOR: 1.67).
  • Requests for hospital admission also significantly increased during the pandemic (aOR: 9.5).

Conclusions:

  • Pandemic conditions led to delayed EMS responses and altered clinical practices for OHCA patients.
  • There is an urgent need to enhance EMS systems to improve on-site interventions and patient outcomes.
  • Strategies to expedite early adrenaline administration are essential for optimizing care during public health crises.
Abstract

Keywords:
covid-19emergency medical servicesintubationout-of-hospital cardiac arrestpandemicspatient care

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