Practices and outcomes of resuscitation in cardiac arrest at a South African Emergency Department

Abstract

Objectives: This study aimed to investigate the patient and resuscitation factors affecting outcome after cardiac arrest in the low-middle income setting. Methods: We retrospectively reviewed the data of patient’s aged ≥18 who experienced in-hospital cardiac arrest in the Emergency Department between January 2020 and December 2020 at a tertiary hospital. The data collection period included the first wave of the COVID-19 pandemic in South Africa. Return of spontaneous circulation (ROSC) was the outcome of interest. The registry from which data was collected was audited. Results: 98 patients were included. The ROSC rate was 43%. Asystole was associated with poor outcomes (likelihood 7.73, p ≤0.01). Cardiac standstill on ultrasound was associated with poor outcome (likelihood ratio 6.559, p ≤0.01). There was a significant improvement in ROSC after the first wave of the COVID-19 pandemic and a transition from airway management with bag-valve-mask to endotracheal intubation intra-arrest (p=0.04). Demographic factors, defibrillation and drug-use were found to have no significant impact. Conclusions: The resuscitation practices and outcomes in the low-middle income setting are similar to high-income settings. Further research on the impact of the COVID-19 pandemic on resuscitation outcomes in this setting is necessary.