Background Following the emergence of COVID-19, there have been local and national changes in the way emergency medical service staff respond to and treat patients in out-of-hospital cardiac arrest. The views of emergency medical service staff on the impacts of COVID-19 on out-of-hospital cardiac arrest resuscitation have not previously been explored. This study aimed to explore the views of emergency medical service staff on the impacts of COVID-19 on out-of-hospital cardiac arrest resuscitation. Methods A qualitative phenomenological enquiry was used to explore the views of emergency medical service staff. A purposive sample of n=20 participants of various clinical grades was selected from National Health Service emergency medical service providers in the UK. Data was collected using semi-structured interviews, transcribed verbatim and analysed using inductive thematic analysis. Results Three main themes were found; service pressures; decision-making and moral injury. The impacts varied according to clinical grade, location and guidelines. COVID-19 reduced resources, availability of staff and in-hospital capacity. Change fatigue was found due to the continuous updates of clinical guidelines. There was a disconnect between guidelines and the clinical practice of staff. Staff generally felt supported to make best interest ethical decisions when resuscitation was ineffective. In certain patient groups, staff increased their risk of transmission, compromising recommended levels of personal protective equipment to improve communication and reduce delays to care. The emotional impacts of prolonged and frequent exposure to patient death were apparent. Conclusion This study found positive outcomes, but also negative impacts important to inform EMS systems. COVID-19 created delays to resuscitation which were multifaceted. Staff developed new ways of working to overcome the barriers of personal protective equipment. There was little impact on resuscitation procedures. Emergency medical service providers should consider how to limit organisational change and better support the emotional responses of staff.

中文翻译：

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EP11 COVID-19 对医院心脏骤停复苏导致的紧急医疗服务的影响：一项定性研究

背景 随着 COVID-19 的出现，地方和国家对紧急医疗服务人员应对和治疗院外心脏骤停患者的方式进行了改变。以前没有探讨过紧急医疗服务人员对 COVID-19 对院外心脏骤停复苏的影响的看法。本研究旨在探讨急诊医疗服务人员对 COVID-19 对院外心脏骤停复苏的影响的看法。方法采用定性的现象学调查方法，探讨急诊医务人员的意见。从英国国家卫生服务紧急医疗服务提供者中选择了 n = 20 名不同临床级别的参与者的有目的的样本。使用半结构化访谈收集数据，逐字转录并使用归纳主题分析进行分析。结果发现了三个主题；服务压力；决策和道德伤害。影响因临床等级、位置和指南而异。COVID-19 减少了资源、工作人员的可用性和住院能力。由于临床指南的不断更新，发现了变化疲劳。指南与工作人员的临床实践之间存在脱节。当复苏无效时，工作人员普遍感到支持做出最佳利益的道德决定。在某些患者群体中，工作人员增加了传播风险，降低了个人防护设备的推荐水平，以改善沟通并减少护理延误。长期和频繁接触患者死亡的情绪影响是显而易见的。结论 这项研究发现了积极的结果，但也发现了对通知 EMS 系统很重要的负面影响。COVID-19 造成了多方面的复苏延误。工作人员开发了新的工作方式来克服个人防护设备的障碍。对复苏程序几乎没有影响。紧急医疗服务提供者应考虑如何限制组织变革并更好地支持员工的情绪反应。