Cardiac arrest survival rates
Email 12/22/2022
Mr ______,
When we have a patient who is in cardiac arrest, if we are able to get a pulse, we document that as ROSC (pronounced rah'sk). It stands for "return of spontaneous circulation".
I had an interesting discussion with my general manager and the clinical services director yesterday. While going over new cardiac arrest protocols that will begin January 1st, my clinical services director mentioned that our ROSC to 'return to normal life' percentage was 14% in 2019. Meaning 14% of the cardiac arrests in which we regained a pulse in the field eventually returned to normal life. He then mentioned that number dropped to around 6.9% in 2020. He says the most current data shows our ROSC to 'return to normal life' rate is still only around 9%.
I asked them why they believe our save rate dropped so rapidly. They both said "covid". I asked "How so?". The answers I was given were all related to problems with treatment (or lack of treatment), not "covid" itself. For example, I remember telling you we weren't allowed to provide any treatment that they believed created aerosols in 2020. So no nebulized albuterol or atrovent for patients with respiratory distress. Orders I refused to follow. Some EMS providers stopped providing any airway treatments at all during cardiac arrests (compressions, drugs, defibrillation only). It doesn't take a genius to know there is no chance of saving anyone without providing airway support.
I then asked them why we haven't seen a return to the 14% rate if we stopped withholding treatments in 2021? They weren't able to give me an answer other than the data is "lagging". At that point the conversation was over. They are both pro-GCI (genetic code injection).
I've said it many times, the SADS patients don't seem to respond to our treatments as well as the unvaxxed cardiac arrests. That 17 year old we had in September was a prime example. It was a witnessed sudden cardiac arrest, he was young and fit, he had early CPR, but his heart never responded to our treatments. I suspect either massive inflammation or massive vascular obstruction somewhere (probably heart or brain). I wonder if this is why our cardiac arrest save rate has remained lower than pre-covid even after we returned to normal protocols.
As for the rest of Atlanta EMS, what I'm currently seeing is that my sickest patients still tend to be the boosted patients. That's not a hard rule, but seems to be a trend. We also seem to have settled into this new normal where not many of my coworkers even ask if our patients have been jabbed anymore. Amazing, and a bit scary, how quick people adjust to "new normals".
-Handy
PS: Merry Christmas. May God's grace fill your home this Christmas season.
In 2020 in the ER in Toronto, there was a caution about even doing compressions, because people would "exhale" aerosolized virus. They were so low on PPE, they were reusing much of what they had used during previous shifts. Nurses in the Portland area went to the full on face sheilds with respirator inserts, that resembled gas masks in Aug of 2021. Interesting how fear cripples people. Takes a lot longer to find solutions. It's a given that the censorship played its roll. But fear has blinded soo many. Too many for too long. Thanks for your articles.