Description of Patients with Out-of-Hospital Cardiac Arrest within 24 Hours of EMS Transport Refusal.

Introduction: Patients refusing transportation is common EMS practice with potentially fatal outcomes. Determining which patients are at high risk for poor outcomes poorly defined. This study described who experienced an out-of-hospital cardiac arrest (OHCA) within 24 hours of transportation. Method: a retrospective, descriptive had OHCA between 2019 to 2021. Data was obtained from large, urban medical control authority seeing 175,000 calls annually. We reviewed patient demographics, events when refused, and outcome. Results: There were 6, 30, 28 refusals resulting in 2019, 2020, 65.7 (range 28-103) years old, African American (54/64). HTN (36/64), diabetes (19/64), COPD (11/64), CHF (7/64). Common complaints included breathing problems (17/64), near syncope (8/64) however chest pain uncommon (4/64). One (28/64) or two (13/64) abnormal vital signs present missing common. Tachycardia (32.8%, 21/64), (29.7%, 19/64), hypotension (17.2%, 11/64) more prevalent the population compared all refusal (Tachycardia 0.33% [1,978/598,416], 2.27% [13,601/598,416], 0.04% [218/598,416]). seen by both ALS (29/64) BLS (35/64) providers. Most providers documented including death (38/64) though few contacted (14/64). Return encounter resulted obvious deaths (23/64) field termination (20/64). Few achieved ROSC Conclusion: transport underlying comorbidities signs. The tachycardia, hypertension, higher rate than overall population. ROSC. Further research needed determine methods mitigate decrease refusals.