Abstract 86: The Impact of Hands-Only™ CPR by Bystanders on Survival in Adult Victims of Out-of-Hospital Arrest Caused by Non-Cardiac Etiologies
Introduction: The use of bystander CPR has demonstrated improved survival in patients with sudden, out of hospital cardiac arrest. Hands-Only™ (chest compression only) CPR is now endorsed by the AHA for these victims. However, patients with arrest due to non cardiac etiologies may also receive Hands Only™ CPR and its impact on survival in these victims is unknown.
Hypothesis: There is no difference in survival for patients treated with conventional versus Hands Only™ bystander CPR following non-cardiac out of hospital arrest (OHA).
Methods: Analysis of an Utstein-style statewide registry of adult OHA, between 10/2004 and 2/2010 was conducted (n = 7517). This registry includes data from 90 communities encompassing ∼80% of the state's population. During the time of this study, a statewide campaign endorsing Hands-Only™ CPR for victims of OHA with a cardiac-etiology was ongoing. This analysis was done to identify the impact of inadvertent provision of Hands-Only™ CPR for non-cardiac OHA. All OHAs of non-cardiac etiology were included for analysis. Outcome measures included whether bystander CPR was performed, the type of CPR preformed (Hands-Only™ v. conventional), and survival to hospital discharge. Fisher's exact test was used to assess statistical significance, α = 0.05.
Results: Non-cardiac causes accounted for 1566 adult OHAs (21.7%). Of these arrests, 60.0% were due to non-cardio-respiratory causes (i.e., drug overdose, suicide, CVA, SAH), 22.5% trauma, 15.4% respiratory arrest, and 2.1% drowning. Bystander CPR was performed in 39%. Survival was: no CPR-3.0%, conventional CPR-4.0%, and Hands-Only™ CPR-3.9%, (p=0.50). In non-cardiac OHA with respiratory causes, the percent of Hands-Only™ CPR to conventional CPR was 9.4%. In comparison, the percent of Hands-Only™ CPR to conventional CPR for cardiac OHA was 71.4%.
Conclusions: In non-cardiac OHA, survival was similar regardless of whether bystander CPR was provided or what type of CPR was performed (conventional vs. Hands-Only™ CPR). Inadvertent provision of Hands-Only™ CPR was infrequent in non cardiac OHA and appears to have no negative impact on outcome. These results may reduce the concern that endorsing Hands-Only™ CPR may compromise outcome in non-cardiac OHA.
- © 2010 by American Heart Association, Inc.