Table 2.

Consequences of COVID-19 on EMS response to OHCA events.

Consequence on EMS Response	Additional Notes	Source
Increased EMS response time as a result of: -COVID-19 phone screening questions -Increased dispatcher workload -Delays in departure due to PPE requirement for personnel	Delays in ambulance departure mostly attributed to need for PPE; ambulance sanitization and increased number of trips are also factors	[7,26]
Fewer resuscitative maneuvers attempted by EMS personnel per OHCA incident	Reduction from 52% to 39% of OHCA events led to resuscitative efforts noted in Padua, Italy	[10]
Need for PPE prior to initiation of resuscitation	Consists of gloves, goggles, and surgical mask Delayed CPR can lead to reduced likelihood of patient survival	[[17], [18], [19], [20], [21], [22]]
BLS and CPR training for EMS personnel on hold	Put on hold due to need for close quarters training and practice with mouth-to-mouth resuscitation	[44]
Decreased incidence of bystander CPR for OHCA events	Additive effects of bystander reluctance, as well as guidance requiring PPE prior to CPR initiation	[26,35]
Inaccessible public AED stations	Closure of locations as a result of lockdowns	[25]
Limited EMS personnel per incident response	Reducing potential exposure while increasing first responder distribution	[25]
Varied rates of resuscitative termination	Decentralization of EMS oversight in urban areas	[36]

OHCA; out of hospital cardiac arrest, EMS; emergency medical service, PPE; personal protective equipment, CPR; cardiopulmonary resuscitation, BLS; basic life support, AED; automated external defibrillator.