Abstract 16089: Effect of Non-targeted Community CPR Education on Bystander CPR Performance
Introduction: Only 37% of OHCA cases receive bystander CPR (bCPR) in Kent County, MI. In May, 2014, prehospital providers offered one-time point-of-care compression-only CPR training (CPR-INT) to passersby at 7 public locations (LOC) in Grand Rapids, the largest city in Kent County. In order to assess the impact of this non-targeted intervention, we compared bCPR frequency and patient outcomes in geographic regions surrounding LOC before and after CPR-INT, adjusting for prehospital covariates.
Hypothesis: CPR-INT had no measurable effect on bCPR performance or outcomes in Kent County.
Methods: Retrospective, observational, population-based study using CARES dataset for Kent County, MI. We included adult, atraumatic, EMS-treated OHCA in Kent County, excluding cases with on-site medical care. We analyzed cases from 4 years before and 2 years after CPR-INT, and generated distance-bounded Thiessen polygons to assign cases within 5 km radius to the nearest LOC. Paired comparisons tested differences in subject features before and after CPR-INT (Table). Difference-in-differences analysis with GEE modeling assessed bCPR performance before and after CPR-INT, adjusting for LOC, covariates (age, sex, witnessed, shockable rhythm, public location), and clustering around LOC. Similar modeling tested for changes in ROSC, survival to hospital discharge (SURV), & CPC 1-2 at hospital discharge.
Results: Characteristics and outcomes of 1,486 subjects are in the Table. AED shock delivery increased, but no other change occurred in subject features, bCPR, or outcomes. CPR-INT was not associated with bCPR performance (β -0.002; 95% CI -0.16, 0.15), ROSC (β -0.06; 95% CI -0.21, 0.25), SURV (β -0.02; 95% CI -0.11, 0.06), & CPC 1-2 (β -0.01; 95% CI -0.07, 0.09).
Conclusions: We observed no impact in bCPR performance or outcomes from a blanket, non-targeted approach to community CPR education. The effect of targeted CPR education in locales with known low bCPR rates should be tested.
Author Disclosures: A. Uber: None. R.C. Sadler: None. T. Chassee: None. J.C. Reynolds: None.
- © 2016 by American Heart Association, Inc.