Abstract 14198: Implementing an Effective Standardized Bystander Cardiopulmonary Resuscitation Protocol for Golf Courses

Abstract

Introduction: A golf course is the fifth most common public place for cardiac arrest (CA). Currently, no standardized protocol exists for bystander CPR in the event of full CA on a golf course. Informal interviews with golfers and golf course personnel strongly suggest incomplete and variable knowledge about what to do in accordance with most current guidelines. Hypothesis: We hypothesize that development and use of a standardized protocol for the three most critical first steps to assure a person’s survival of an on-golf course CA, including calling 911, initiating high quality bystander CPR with guideline based chest compressions and early defibrillation with a standardized automated external defibrillator (AED) will improve chances of surviving if playing partners, caddies and club staff are well prepared to respond urgently to such an emergency. Methods: We created a four-panel laminated infographic designed to fit easily into every golfer’s bag, assuring a readily available “911-CPR-AED” guide for lay bystanders to initiate chest compressions, notifying the Golf Shop Personnel for getting an AED and any BLS certified persons out to arrest site as fast as possible to deliver defibrillation, and simultaneously readying the golf course grounds crew to meet the arriving rescue ambulance at the front entrance to the course and escorting them quickly and safely out to the CA site. All aspects of this process were shared and approved by leaders of the closest Emergency Medical System (EMS) and hospital emergency department (ED). Results: We simulated with all key stakeholders a full on-course cardiac arrest and 911 call to EMS in accordance with the infographic protocol, including victim resuscitation of a standard CPR mannikin and onsite rescue by paramedics. Bystander CPR was immediately initiated, AED delivered at 3 minutes, ambulance arrival at 6 minutes and full advanced cardiac life support delivered at this time with return of blood pressure. EMS loaded the victim into the ambulance at 12 minutes and was escorted back to the front entrance of the course and then to the local ED. The 911-CPR-AED infographic has now been distributed to all golfers, caddies and staff. Conclusion: An effective, standard bystander CPR protocol now exists for use at any US golf course.