Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 May 18;22(1):85.
doi: 10.1186/s12873-022-00628-2.

Observational study on implications of the COVID-19-pandemic for cardiopulmonary resuscitation in out-of-hospital cardiac arrest: qualitative and quantitative insights from a model region in Germany

Domagoj Damjanovic #  1 , Jan-Steffen Pooth #  2 , Rebecca Steger  3 , Martin Boeker  4 , Michael Steger  3 , Julian Ganter  2 , Tobias Hack  2 , Klemens Baldas  5 , Paul Marc Biever  6 , Daniel Schmitz  5 , Hans-Jörg Busch  3 , Michael Patrick Müller  5 , Georg Trummer  2 , Bonaventura Schmid  3
Affiliations
Review

Observational study on implications of the COVID-19-pandemic for cardiopulmonary resuscitation in out-of-hospital cardiac arrest: qualitative and quantitative insights from a model region in Germany

Domagoj Damjanovic et al. BMC Emerg Med. .

Abstract

Background: The city of Freiburg has been among the most affected regions by the COVID-19 pandemic in Germany. In out of hospital cardiac arrest (OHCA) care, all parts of the rescue system were exposed to profound infrastructural changes. We aimed to provide a comprehensive overview of these changes in the resuscitation landscape in the Freiburg region.

Methods: Utstein-style quantitative data on OHCA with CPR initiated, occurring in the first pandemic wave between February 27th, 2020 and April 30th, 2020 were compared to the same time periods between 2016 and 2019. Additionally, qualitative changes in the entire rescue system were analyzed and described.

Results: Incidence of OHCA with attempted CPR did not significantly increase during the pandemic period (11.1/100.000 inhabitants/63 days vs 10.4/100.000 inhabitants/63 days, p = 1.000). In witnessed cases, bystander-CPR decreased significantly from 57.7% (30/52) to 25% (4/16) (p = 0.043). A severe pre-existing condition (PEC) was documented more often, 66.7% (16/24) vs 38.2% (39/102) there were longer emergency medical services (EMS) response times, more resuscitation attempts terminated on scene, 62.5% (15/24) vs. 34.3% (35/102) and less patients transported to hospital (p = 0.019). Public basic life support courses, an app-based first-responder alarm system, Kids Save Lives activities and a prehospital extracorporeal CPR (eCPR) service were paused during the peak of the pandemic.

Conclusion: In our region, bystander CPR in witnessed OHCA cases as well as the number of patients transported to hospital significantly decreased during the first pandemic wave. Several important parts of the resuscitation landscape were paused. The COVID-19 pandemic impedes OHCA care, which leads to additional casualties. Countermeasures should be taken.

Keywords: Bystander CPR; COVID-19; Cardiac arrest; Cardiopulmonary resuscitation; Chain of survival; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

DD has been a part-time employee at Resuscitec GmbH, Freiburg from 2018 to 2020, JSP is a part-time employee at Resuscitec GmbH, Freiburg currently. MPM is member of the executive committee of the GRC, chair of the charity organization “Region of Lifesavers” (RDL), which is responsible to operate a smartphone alerting system, and shareholder of SmartResQ ApS, Svendborg/ Denmark. GT is a board member of the GRC and part-time employee at Resuscitec GmbH, Freiburg. RS, MB, MS, JG, TH, KB, PMB, DS, HJB and BS declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Incidence of COVID-19 (dotted line) vs incidence of OHCA in the same time frame of 2020 (solid line) compared to the years 2016–2019 (interrupted line). Incidence of OHCA did not significantly differ in 2020 compared to the previous years (p = 1)
Fig. 2
Fig. 2
CPR initiated by bystander by year. The increase in 2019 compared to the other years was not statistically significant (p = 0.0799)
Fig. 3
Fig. 3
CPR initiated when CA witnessed by year
Fig. 4
Fig. 4
Patients declared dead on scene by year
See this image and copyright information in PMC

References

    1. Office for citizen service, city of Freiburg. Number of inhabitants Freiburg. Bevölkerung und Wohnen. 2020. Available from: https://www.freiburg.de/pb/207904.html. Last accessed 09.07.2020.
    1. Damjanovic D, Bürchner J, Ott M, Geldner G. “Löwen retten Leben” – a federal state wide kids save lives project in Germany. Resuscitation. 2018;130:e66.
    1. Busch H-J, Schmid B, Kron J, Fink K, Busche C, Danner T, et al. Freiburger cardiac arrest receiving team (CART) Med Klin Intensivmed Notfallmed. 2020;115(4):292–299. doi: 10.1007/s00063-019-0598-z. - DOI - PubMed
    1. Rott N, Scholz KH, Busch HJ, Frey N, Kelm M, Thiele H, et al. Cardiac arrest center certification for out-of-hospital cardiac arrest patients successfully established in Germany. Resuscitation. 2020;156:1–3. doi: 10.1016/j.resuscitation.2020.08.007. - DOI - PMC - PubMed
    1. Robert Koch-Institut . COVID-19-Dashboard. 2020.

Publication types