Thread by @teddyhla

Next : Mypinder SEKHON on cardiac arrest in COVID-19 era.

Works in Vancouver
COVID 19 era cardiac arrest ARE a lot less sexy with all the PPE. #als #covid19 #resuscitation #LIVES2022
@ESICM

@ESICM Let's look at epidemiology. Northern Italy, Manhattan - COVID hit hard and has impact on other diseases.

e.g., OHCA in Italy during COVID 19 massive spike.

jamanetwork.com/journals/jamac…

Demographcis also change == in reference to White ethnicity, other ethnicity has higher Odds ratio (this is in keeping with higer risk for COVID in these patients)

Rhythm : also reduction in shockable rhythms and high PEA/Asystole
#covid19 #LIVES2022

Summary : a lot more ohca. A lot more in ethnic groups. A lot more non shockable rhythms

outcomes also much worse
- less ROSC
- less sustained ROSC

Why are we seeing these outcomes?
#LIVES2022
we need to follow change of care
#COVID19 #ALS
pre-hospital, EMS and ED / ICU chain of care.
pre-hosp : low bystander CPR & lower use of public CPR (closed public buildings)

- non shockable rhythm probably because shockable patients deteriorate further into cardiac arrest
- paramedics were overwhelmed, EMS response times go up
- overwhelmed health care systems
- allocation of resources issues

so in summary.

outcomes got significantly worse
- lower ROSC
- lower survival to hospital
So
- need a health system based response
- e.g., CPR training + AEDs in more easily accessible public spaces
AND MOST IMPORTANT IS "STAFF"
- in ED, in Prehospitla, in ICU's
#COVID19 #LIVES2022

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