Degree of Change in Bystander Cardiopulmonary Resuscitation Rate During the Onset of the Global COVID-19 Pandemic in the State of Michigan

Abstract

The purpose of this study is to understand how COVID-19 has affected bystander performance of cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients. Studies have shown that bystander CPR can double or triple a person's chance of survival. However, during the onset and aftermath of the global COVID-19 pandemic, the risk for COVID-19 exposure during CPR for OHCA is a significant concern for bystanders. I hypothesize that, as a result of COVID-19 pandemic, the rates of bystander CPR have decreased significantly. To test this hypothesis, I conducted a quantitative research study by using data from the Cardiac Arrest Registry to Enhance Survival (CARES) registry - a nationwide central registry of OHCA data collected from emergency medical services (EMS) agencies. For this study, Michigan CARES data from January 1 to June 30, 2019 and from January 1 to June 30, 2020 were compared. In a comparison of 844 OHCA in 2019 and 8591 in 2020, the proportion of cases receiving bystander CPR was lower in 2020 (25% vs 28%, p = 0.78); An increased proportion of OHCA occurred in the home (86% vs. 82%, p = 0.44), and decreased proportion in public spaces (14% vs 18%, p = 0.16). There were more monthly OHCA cases overall on average (143 vs 141, p = 0.79) and the survival to hospital admission rate was lower during pandemic period (25% vs 28%, p = 0.24). Per my analysis, the decrease in the rate of bystander CPR in 2020 during the pandemic is not statistically significant. However, it is reassuring that the COVID-19 pandemic did not seem to significant impact the rate of bystander CPR as we know that early CPR is critical to optimal outcomes for people experiencing OHCA and for the professionals who work to maximize the rate of bystander CPR during OHCA.