Impact of COVID-19 pandemic on emergency medical service response to emergency calls — a retrospective analysis of data from Emergency Medical Service station in Bydgoszcz
Abstract
Introduction: Emergency medical systems, as the first line of management of infectious patients, were affected by the 2019 coronavirus acute respiratory disease (COVID-19) pandemic. The aim of the study was to analyze the impact of the COVID-19 pandemic on the Emergency Medical Service (EMS) with emphasis on response time.
Material and methods: Retrospective analysis of dispatch card from EMS in Bydgoszcz between January 2018 and December 2020. The differences regarding the EMS response were analyzed between the pre-pandemic (2018–2019) and the pandemic (2020) period in three time-points: from call to Emergency Medical Team (EMT) departure (T1), from departure to arrival at the scene (T2), and from arrival to reaching the emergency department (T3).
Results: There were 47783 EMT departures in 2018, 47113 in 2019 and 40835 in 2020. In 2020 mean (SD) monthly number of interventions was significantly lower [3403 (349) vs. 3954 (182), p < 0.001) compared to the 2018–2019 period. During the pandemic period the mean T1 [0.9 (1.49) vs. 0.63 (1.12) min, p < 0.001], T2 [9.91 (6.33) vs. 8.25 (5.07) min, p < 0.001], and T3 interval [40.45 (19.84) vs. 36.56 (14.63) min, p < 0.001] were prolonged in comparison to the pre-pandemic period. The differences in response time were the largest in October–December.
Conclusions: During the first year of the pandemic, the number of EMT interventions decreased and the response time was prolonged compared to the pre-pandemic period. The largest differences were observed at the end of the year, which overlapped with the peak of the second wave of COVID-19 infections in Poland.
Keywords: COVID-19emergency medical servicepandemicresponse time
References
- World Health Organization (WHO). COVID-19 weekly epidemiological update, edition 77, 1 February 2022. https://apps.who.int/iris/handle/10665/351517 (16.02.2022).
- Koronawirus: informacje i zalecenia. Raport zakażeń koronawirusem (SARS-CoV-2). https://www.gov.pl/web/koronawirus/wykaz-zarazen-koronawirusem-sars-cov-2 (26.06.2022).
- Dodt C, Schneider N. Emergency and intensive care medicine aspects of COVID-19 infections [in German]. Radiologe. 2020; 60(10): 899–907.
- Nadolny K, Szczerbiński S, Ładny J, et al. Out-of-hospital cardiac arrest and COVID-19 pandemic. Med Res J. 2021; 6(2): 83–85.
- Kelker H, Yoder K, Musey P, et al. Prospective study of emergency medicine provider wellness across ten academic and community hospitals during the initial surge of the COVID-19 pandemic. BMC Emerg Med. 2021; 21(1): 36.
- Rodriguez RM, Medak AJ, Baumann BM, et al. Academic emergency medicine physicians' anxiety levels, stressors, and potential stress mitigation measures during the acceleration phase of the COVID-19 pandemic. Acad Emerg Med. 2020; 27(8): 700–707.
- Chojecka D, Pytlos J, Zawadka M, et al. How to maintain safety and maximize the efficacy of cardiopulmonary resuscitation in COVID-19 patients: insights from the recent guidelines. J Clin Med. 2021; 10(23).
- Mohammadi F, Tehranineshat B, Bijani M, et al. Management of COVID-19-related challenges faced by EMS personnel: a qualitative study. BMC Emerg Med. 2021; 21(1): 95.
- Garcia-Castrillo L, Petrino R, Leach R, et al. European Society For Emergency Medicine position paper on emergency medical systems' response to COVID-19. Eur J Emerg Med. 2020; 27(3): 174–177.
- Ahn JY, Ryoo HW, Cho JW, et al. Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study. Clin Exp Emerg Med. 2021; 8(2): 137–144.
- Baldi E, Sechi GM, Mare C, et al. all the Lombardia CARe researchers. Treatment of out-of-hospital cardiac arrest in the COVID-19 era: A 100 days experience from the Lombardy region. PLoS One. 2020; 15(10): e0241028.
- Baldi E, Auricchio A, Klersy C, et al. SWISSRECA researchers. Out-of-hospital cardiac arrests and mortality in Swiss Cantons with high and low COVID-19 incidence: A nationwide analysis. Resusc Plus. 2021; 6: 100105.
- Ball J, Nehme Z, Bernard S, et al. Collateral damage: Hidden impact of the COVID-19 pandemic on the out-of-hospital cardiac arrest system-of-care. Resuscitation. 2020; 156: 157–163.
- Chan PS, Girotra S, Tang Y, et al. Outcomes for out-of-hospital cardiac arrest in the united states during the coronavirus disease 2019 pandemic. JAMA Cardiol. 2021; 6(3): 296–303.
- Cho JW, Jung H, Lee MiJ, et al. WinCOVID-19 consortium. Preparedness of personal protective equipment and implementation of new CPR strategies for patients with out-of-hospital cardiac arrest in the COVID-19 era. Resusc Plus. 2020; 3: 100015.
- Fothergill RT, Smith AL, Wrigley F, et al. Out-of-hospital cardiac arrest in London during the COVID-19 pandemic. Resusc Plus. 2021; 5: 100066.
- Glober NK, Supples M, Faris G, et al. Out-of-hospital cardiac arrest volumes and characteristics during the COVID-19 pandemic. Am J Emerg Med. 2021; 48: 191–197.
- Lai PH, Lancet EA, Weiden MD, et al. Characteristics associated with out-of-hospital cardiac arrests and resuscitations during the novel coronavirus disease 2019 pandemic in new york city. JAMA Cardiol. 2020; 5(10): 1154–1163.
- Lim D, Park SYi, Choi B, et al. The comparison of emergency medical service responses to and outcomes of out-of-hospital cardiac arrest before and during the COVID-19 pandemic in an area of korea. J Korean Med Sci. 2021; 36(36): e255.
- Marijon E, Karam N, Jost D, et al. Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. Lancet Public Health. 2020; 5(8): e437–e443.
- Nishiyama C, Kiyohara K, Iwami T, et al. Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan. Resusc Plus. 2021; 5: 100088.
- Rosell Ortiz F, Fernández Del Valle P, Knox EC, et al. OHSCAR investigators. Influence of the Covid-19 pandemic on out-of-hospital cardiac arrest. A Spanish nationwide prospective cohort study. Resuscitation. 2020; 157: 230–240.
- Semeraro F, Gamberini L, Tartaglione M, et al. Out-of-hospital cardiac arrest during the COVID-19 era in Bologna: System response to preserve performances. Resuscitation. 2020; 157: 1–2.
- Sultanian P, Lundgren P, Strömsöe A, et al. Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation. Eur Heart J. 2021; 42(11): 1094–1106.
- Uy-Evanado A, Chugh HS, Sargsyan A, et al. Out-of-hospital cardiac arrest response and outcomes during the COVID-19 pandemic. JACC Clin Electrophysiol. 2021; 7(1): 6–11.
- Yu JH, Liu CY, Chen WK, et al. Impact of the COVID-19 pandemic on emergency medical service response to out-of-hospital cardiac arrests in Taiwan: a retrospective observational study. Emerg Med J. 2021; 38(9): 679–684.
- Seo AhR, Lee WJ, Woo SH, et al. Pre-hospital delay in patients with acute stroke during the initial phase of the coronavirus disease 2019 outbreak. J Korean Med Sci. 2022; 37(6): e47.
- Bielski K, Szarpak A, Jaguszewski MJ, et al. The influence of COVID-19 on out-hospital cardiac arrest survival outcomes: an updated systematic review and meta-analysis. J Clin Med. 2021; 10(23).
- Biuletyn Informacji Publicznej - Starostwo Powiatowe w Bydgoszczy: Dane statystyczne [Public Information Bulletin]. https://bip.powiat.bydgoski.pl/?c=17 (18.02.2022).
- Al Amiry A, Maguire BJ. Emergency Medical Services (EMS) calls during COVID-19: early lessons learned for systems planning (A narrative review). Open Access Emerg Med. 2021; 13: 407–414.
- Steinman M, de Sousa JH, Tustumi F, et al. The burden of the pandemic on the non-SARS-CoV-2 emergencies: A multicenter study. Am J Emerg Med. 2021; 42: 9–14.
- Nadolny K, Ładny JR, Zyśko D, et al. Interventions of emergency medical teams in Poland during the SARS-CoV-2 pandemic. Kardiol Pol. 2021; 79(1): 72–75.
- Szczerbinski S, Ratajczak J, Lach P, et al. Epidemiology and chronobiology of out-of-hospital cardiac arrest in a subpopulation of southern Poland: A two-year observation. Cardiol J. 2020; 27(1): 16–24.
- Ratajczak J, Łach P, Umińska JM, et al. Mild therapeutic hypothermia after out-of-hospital cardiac arrest: What does really matter? Cardiol J. 2021; 28(2): 293–301.
- Szczerbiński S, Ratajczak J, Jasiewicz M, et al. Observational analysiS of out-of-hospital cardiac arrest occurRence and temporal variability patterns in subpopulation of southern poland from 2006 to 2018: OSCAR-POL registry. Cardiol J. 2021 [Epub ahead of print].
- Bruska M, Szankin Z, Ratajczak J, et al. Improvement of the quality of cardiopulmonary resuscitation performed with Real CPR Help® device among medical students and medical workers. Medical Research Journal. 2021; 6(3): 177–183.
- Lackowski P, Piasecki M, Kasprzak M, et al. COVID-19 pandemic year in the cardiology department. Med Res J. 2021; 6(1): 40–46.
- Walton H, Navaratnam AV, Ormond M, et al. Emergency medicine response to the COVID-19 pandemic in England: a phenomenological study. Emerg Med J. 2020; 37(12): 768–772.