The impacts on bystander and dispatcher-assisted cardiopulmonary resuscitation during COVID-19 pandemic

Purpose: The impact of emerging infections disease pandemic such as COVID-19 on bystander CPR performance is not well known Materials-and-methods: This was an observational database prospectively collected from National Registry for DACPR (dispatcher-assisted CPR), a continuous quality control for OHCA by audio records analyses of EMS calls The performance of DACPR before and after the COVID-19 epidemic was compared among four individual EMS systems (three metropolitan and one suburban) The bystander chest compressions (BCC) rate prior to the call, successful delivery of BCC after dispatcher-assisted, and the continuity of CC until hand-over by the paramedics after arrival (HCC) as the categorical indicators, and the operational time interval corresponding to call-to-compression were evaluated and analyzed using Pearson's chi-squared test, Independent t-test, and Kruskal–Wallis test with SPSS Version 22 Results: In a total of 3263 eligible patients from four EMS systems, for patients already receiving BCC prior to the call, though showing a tendency of decrease, there were no significant differences after the epidemics (A: 3 6% vs 5 7%, p = 0 13;B: 4 5% vs 6 1%, p = 0 46;C: 6 0% vs 6 6%, p = 0 71;D: 6 8% vs 10 7%, p = 0 59;Total: 4 9% vs 6 4%, p = 0 11) For dispatcher-assisted BCC delivery, a metropolitan (B) significantly decreased and the suburban (D) significantly increased (A: 55 0% vs 56 1%, p = 0 72;B: 41 8% vs 52 3%, p = 0 03;C: 60 6% vs 56 5%, p = 0 19;D: 83 0% vs 60 2%, p < 0 01;Total: 56 8% vs 55 6%, p = 0 53) For continuity of HCC, a metropolitan(C) and the suburban (D) both significantly increased as well as the total cases (A: 43 9% vs 46 4%, p = 0 43;B: 28 5% vs 31 0%, p = 0 56;C: 54 0% vs 40 0%, p < 0 01;D: 77 4% vs 59 3%, p = 0 02;Total: 47 4%vs 41 3%, p < 0 01) For call-to-compression interval, all regions showed a tendency to be faster without significance (A: 185 vs 189 s, p = 0 8;B: 141 vs 156 s, p = 0 19;C: 173 vs 182 s, p = 0 12;D: 156 vs 171 s, p = 0 27;Total: 164 vs 172 s, p = 0 19) Conclusions: The impacts of COVID-19 pandemic showed a tendency to decrease BCC prior to dispatcher-assisted, and were significantly varied for dispatcher-assisted BCC among different EMS systems, however the timely BCC would not be delayed Continuity of BCC even significantly increased under the national continuous auditing