Abstract 16021: Quality of Layperson Bystander Cardiopulmonary Resuscitation During Real Life Out-of-hospital Cardiac Arrest
Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death. Early basic life support increases survival, however the effect is dependent on the quality of cardiopulmonary resuscitation (CPR). While bystander CPR quality primarily has been investigated in controlled, simulated cardiac arrest scenarios, limited is known about CPR quality by laypersons in real life OHCA.
Aim: To describe the quality of bystander CPR based on information from automated external defibrillator (AED) CPR process data during OHCA and to evaluate the results compared with the 2015 American Heart Association Resuscitation Guidelines.
Methods: All cases of public OHCA in the Capital Region of Denmark where an AED (ZOLL AED Plus®) was used for bystander CPR prior to ambulance arrival was included. We included 86 cases with at least one continuous full minute of data. Data was analyzed for the initial 10 minutes of CPR using RescueNet™ Code Review 5.71 that calculates compression rate (CR), depth (CD) and fraction (CF) delivered for each minute of CPR.
Results: Median analysis period was 4 min [2;7]. The initial rhythm was shockable in 47% (n=40) of cases.
Bystanders compressed with a mean CR of 104 min-1 (SD15), a CD of 5.0 cm (SD 1.4) and a CF of 58% (SD 16). Mean CR was within the range of 100-120 min-1 in 51% (n=43), below in 36% (n=31) and above in 11% of all cases (n=11). CD was between 5-6 cm in 35% (n=30), below in 46% (n=39) and above in 19 % of cases (n=16). CF was below the recommended 60% in 50% of cases (n=43).
During the entire resuscitation period a median of 40 % [IQR 0;75] of total resuscitation time CR was 100-120 min-1, whereas CD was between 5-6 cm in 14% [IQR 0;50] of the time. Pauses due to defibrillation had a median length of 27 seconds [IQR 22;30]. The duration of pre-shock pauses were 19 seconds [IQR 17;21] while the prompted pre-shock pause was 15 seconds [IQR 14;18].
Conclusion: Bystanders using AEDs with real time audio feedback in OHCA are able to perform quality CPR. However, only in 40% of the total resuscitation period did bystanders perform chest compressions at the recommended rate and 14% of the resuscitation period for compression depth. Furthermore, none of the pre-shock pauses where below recommended 10 seconds, in part due to the prompted pre-shock pause of 15 seconds.
- Cardiopulmonary resuscitation
- Cardiac arrest
- Automated external defibrillator (AED)
- Chain of survival
- Chest compression
Author Disclosures: T. Gyllenborg: None. A. Granfeldt: None. F. Lippert: None. I.S. Riddervold: None. F. Folke: None.
- © 2016 by American Heart Association, Inc.