Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation

Abella, Benjamin S.; Aufderheide, Tom P.; Eigel, Brian; Hickey, Robert W.; Longstreth, W. T.; Nadkarni, Vinay; Nichol, Graham; Sayre, Michael R.; Sommargren, Claire E.; Hazinski, Mary Fran

doi:10.1161/circulationaha.107.188486

Cited by 134 publications

(68 citation statements)

References 40 publications

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“…The Community CPR Take 10 Program conducted in the United States, for example, targeted CPR education in high‐risk regions and saw a subsequent increase in CPR rates 20. More recent programs are now using different training strategies, (eg, classes, self‐instruction, online)21 to overcome the barriers of time and cost, and the promotion of hands‐only (or compression‐only) CPR is now encouraged internationally, especially for bystanders who are not trained in CPR 22, 23…”

Section: Discussionmentioning

confidence: 99%

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Bray

Straney

Smith

et al. 2017

JAHA

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BackgroundBystander cardiopulmonary resuscitation (CPR) more than doubles the chance of surviving an out‐of‐hospital cardiac arrest. Recent data have shown considerable regional variation in bystander CPR rates across the Australian state of Victoria. This study aims to determine whether there is associated regional variation in rates of CPR training and willingness to perform CPR in these communities.Methods and ResultsWe categorized each Victorian postcode as either a low or high bystander CPR region using data on adult, bystander‐witnessed, out‐of‐hospital cardiac arrests of presumed cardiac etiology (n=7175) from the Victorian Ambulance Cardiac Arrest Registry. We then surveyed adult Victorians (n=404) and compared CPR training data of the respondents from low and high bystander CPR regions. Of the 404 adults surveyed, 223 (55%) resided in regions with low bystander CPR. Compared with respondents from high bystander CPR regions, respondents residing in regions with low bystander CPR had lower rates of CPR training (62% versus 75%, P=0.009) and lower self‐ratings for their overall knowledge of CPR (76% versus 84%, P=0.04). There were no differences between the regions in their reasons for not having undergone CPR training or in their willingness to perform CPR. Rates of survival for bystander‐witnessed, out‐of‐hospital cardiac arrests were significantly lower in low bystander CPR regions (15.7% versus 17.0%, P<0.001).ConclusionsThis study found lower rates of CPR training and lower survival in regions with lower rates of bystander CPR in Victoria, Australia. Targeting these regions with CPR training programs may improve bystander CPR rates and out‐of‐hospital cardiac arrest outcomes.

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Section: Discussionmentioning

confidence: 99%

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Bray

Straney

Smith

et al. 2017

JAHA

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“…Bystanders are reluctant to perform chest compression because of fear of causing harm, fear of litigation, the complexity of performing mouth‐to‐mouth rescue breathing, and the unwillingness to perform mouth‐to‐mouth contact 4, 5, 6. Bystanders’ reluctance may be due to their insufficient knowledge, skills, or confidence.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Tsunoyama

Nakahara

Yoshida

et al. 2017

Acute Medicine & Surgery

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AimThe Japanese government has developed a standardized training program for emergency call dispatchers to improve their skills in providing oral guidance on chest compression to bystanders who have witnessed out‐of‐hospital cardiac arrests (OHCAs). This study evaluated the effects of such a training program for emergency call dispatchers in Japan.MethodsThe analysis included all consecutive non‐traumatic OHCA patients transported to hospital by eight emergency medical services, where the program was implemented as a pilot project. We compared the provision of oral guidance and the incidence of chest compression applications by bystanders in the 1‐month period before and after the program. Data collection was undertaken from October 2014 to March 2015.ResultsThe 532 non‐traumatic OHCA cases were used for analysis: these included 249 cases before and 283 after the guidance intervention. Most patients were over 75 years old and were men. After the program, provision of oral guidance to callers slightly increased from 63% of cases to 69% (P = 0.13) and implementation of chest compression on patients by bystanders significantly increased from 40% to 52% (P = 0.01). Appropriate chest compression also increased from 34% to 47% (P = 0.01). In analysis stratified by the provision of oral guidance, increased chest compressions were observed only under oral guidance.ConclusionsWe found increased provision of oral guidance by dispatchers and increased appropriate chest compressions by bystanders after the training program for dispatchers had been rolled out. Long‐term observation and further data analysis, including patient outcomes, are needed.

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“…The prognosis of OHCA prominently depends on initial bystander actions as described in the concept of 'chain-of-survival' [2]. Unfortunately, bystanders initiate cardiopulmonary resuscitation (CPR) on their own initiative in less than one-third OHCAs [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with quality of bystander CPR: The presence of multiple rescuers and bystander-initiated CPR without instruction

et al. 2014

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Aims:To identify the factors associated with good-quality bystander cardiopulmonary resuscitation (BCPR). Multiple logistic regression analysis indicated that multiple rescuers (odds ratio=2.8, 95% CI: 1.5-5.6), bystander-initiated BCPR (2.7, 1.1-7.3), non-elderly bystanders (1.9, 1.1-3.2), occurrence in the central region (2.1, 1.3-3.3) and duration of BCPR (1.1, 1.0-1.1) were associated with good-quality BCPR. Moreover, good-quality BCPR was initiated earlier after recognition/witness of cardiac arrest compared with poor-quality BCPR (3 vs. 4 min, p=0.0052). MethodsThe rate of neurologically favourable survival at one year was 2.7% and 0% in the good-quality and poor-quality groups, respectively (p=0.1357). Conclusions:The presence of multiple rescuers and bystander-initiated CPR are predominantly associated with good-quality BCPR.

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Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation

Cited by 134 publications

References 40 publications

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Factors associated with quality of bystander CPR: The presence of multiple rescuers and bystander-initiated CPR without instruction

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