Abstract 3: The Save Hearts in Arizona Registry and Education (SHARE) Program: Who is Performing Cardiopulmonary Resuscitation and Where are They Doing It?
Background: Bystander initiated CPR significantly decreases mortality from out-of-hospital cardiac arrest and the vast majority of cardiac arrests occur away from trained medical personnel. Layperson initiated CPR is an integral component in the AHA chain of survival for out-of-hospital cardiac arrest victims.
Objective: Determine the rate of true layperson initiated CPR and examine the relationship between layperson CPR and location of arrest.
Methods: We reviewed EMS first care reports voluntarily submitted by 30 municipal fire departments in Arizona to the SHARE Program. In addition to standard Utstein style data, information regarding the performance of bystander initiated CPR, the vocation and medical training of the bystander, and the location of the arrest was documented. Outcome data was obtained using the Arizona Department of Health Services Office of Vital Statistics.
Results: The total number of adult arrests of presumed cardiac etiology reported statewide was 1,097. Arrests occurred in residential locations in 67%, extended care or medical facilities in 18%, and public locations in 15%. Bystander CPR was performed in 37% of all arrests; 24% of residential arrests, 76% of extended care or medical facility arrests, and 52% of public arrests. It provided an odds ratio of 2.2 for survival [95% CI 1.2–4.1]. Bystanders performing CPR had formal training in CPR as part of their job description in 16% of residential arrests, 94% of extended care or medical facility arrests, and 15% of public arrests. Excluding the arrests which occurred in the presence of a bystander with formal CPR training as part of their job description, layperson initiated CPR was performed in 218 of 857 (25%) of cases. Layperson initiated CPR was performed by family members in 54% of arrests, friends/neighbors in 24% of arrests, and strangers in 22% of arrests. The training of the bystander did not significantly effect survival.
Conclusions: The incidence of true layperson initiated CPR is extremely low. This low rate of bystander initiated CPR likely contributes to the low overall survival rates from cardiac arrest. Public health officials must reconsider current models of educating the public on CPR.