Public knowledge and attitudes towards bystander cardiopulmonary resuscitation (CPR) in Ghana, West Africa

Abstract

Background and objectives Early bystander cardiopulmonary resuscitation (CPR) is one of the most important predictors of out-of-hospital cardiac arrests (OHCA) survival. There is a dearth of literature on CPR engagement in countries such as Ghana, where cardiovascular events are increasingly prevalent. In this study, we sought to evaluate Ghanaians’ knowledge of and attitudes towards bystander CPR, in the context of the country’s nascent emergency medicine network. Methods Capitalizing on the growing ubiquity and use of social media across the country, we used a novel social media sampling strategy for this study. We created, pre-tested, and distributed an online survey, using the two most utilized social media platforms in Ghana: WhatsApp and Facebook. An airtime data incentive of 5 US dollars, worth between 5 and 10 GB of cellular data based on mobile phone carrier, was provided as incentive. Inclusion criteria were (1) ≥ 18 years of age, (2) living in Ghana. Survey participants were encouraged to distribute the survey within their own networks to expand its reach. We stratified participants’ responses by healthcare affiliation, and further grouped healthcare workers into ambulance and non-ambulance personnel. We used chi-square (χ2)/Fisher’s Exact tests to compare differences in responses between the groups. Based on the question “have you ever heard of CPR?”, an alpha of 0.05 and a 95% confidence interval, we expected to have 80% power to detect a 15% difference in responses between lay and healthcare providers with an estimated sample size of 246 study participants. Results The survey was launched on 8 July 2019 and closed approximately 51 h post-launch. With a 64% completion rate and 479 unique survey completions, the study was overpowered at 96% power, to detect differences in responses between the groups. There was geographic representation across all 10 historic regions of Ghana. Over half (57.8%, n = 277) of the respondents were non-medically affiliated, and 71.9% were women. Healthcare workers were more aware of CPR than lay respondents (96.5% vs 68.1%; p < 0.001). Eighty-five percent of respondents were aware that CPR involves chest compressions, and almost 70% indicated that “mouth to mouth” is a necessary component of CPR. Fewer than 10% were unwilling to administer CPR. Lack of skills (44.9%) and fear of causing harm (25.5%) were barriers noted by respondents for not administering CPR. Notably, a quarter of ambulance workers reported never having received CPR training. If they were to witness a collapse, 62.0% would call an ambulance, and 32.6% would hail a taxi. Conclusion The majority of participants are willing to perform CPR. Contextualized training that emphasizes hands-only CPR and builds participants’ confidence may increase bystander willingness and engagement.

Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review

“…c) For example, village or community hall, school (not as a student). China, Unknown year 31 Chinal, 2019 30 Costa Rica, 2014 34 Ghana, 2019 35 Indonesia, 2016 38 South Korea, 2007 45 South Korea, 2011 45 South Korea, 2015 45 Oman, Unknown year 53 Poland, 1997 54 Portugal, 2012 55 Russia, 2018 58 Australia, 2017 23 Spain, 2015 62 Sweden, 2000 64 Global prevalence of resuscitation training studies, clarifies the study design and the conduct of the research, identifies the knowledge gaps, and may inform future systematic reviews on the topic. The findings may be utilized by national and international authorities when planning public health initiatives directed at improving bystander CPR rates and increasing the survival rates after OHCA.…”

“…4). 8,9,15,18,19,22,23,27,29,35,36,39,42,[44][45][46]49,51,52,58,61,62,65,67,71,74,81 Several studies investigated the prevalence of CPR training in the same population and geography in different study periods. These studies were carried out in four countries: Australia, China, Japan, and South Korea.…”

Cardiac Arrest Survival Post-Electrocution – Management in a Low-Resource Emergency Department in Ghana: A Case Series

“…By-stander CPR is recommended for all cases of unresponsiveness especially in the case of electrocution after verified scene safety. 5 In developing countries, the concept of Basic Life Support (BLS) or by-stander CPR has not gained much prominence, 12 therefore majority of unresponsive patients or victims of sudden collapse in these countries, presenting to the ED do not receive any form of CPR on scene or en-route the hospital.…”

Ethik der Reanimation und Entscheidungen am Lebensende

“…In der Rate der Ersthelferreanimationen gibt es deutliche Unterschiede zwischen Ländern, Regionen und sogar in Bezug auf die äußeren Umstände oder Patienteneigenschaften [ 226 , 232 – 235 ].…”