Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)?—a nation-wide public survey

Abstract

BackgroundBystander cardiopulmonary resuscitation (CPR) improves the likelihood of survival from out-of-hospital cardiac arrest (OHCA), yet it is performed in only 30% of cases. The 2010 guidelines promote chest-compression-only bystander CPR—a change intended to increase willingness to provide CPR.Objectives1) To determine whether the Canadian general public is more willing to perform chest-compression-only CPR compared to traditional CPR; 2) to characterize public knowledge of OHCA; and 3) to identify barriers and facilitators to bystander CPR.MethodsA 32-item survey assessing resuscitation knowledge, and willingness to provide CPR were disseminated in five Canadian regions. Descriptive statistics were used to characterize response distribution. Logistic regression analysis was applied to assess shifts in intention to provide CPR.ResultsA total of 428 completed surveys were analysed. When presented with a scenario of being a bystander in an OHCA, a greater proportion of respondents were willing to provide chest-compression-only CPR compared to traditional CPR for all victims (61.5% v. 39.7%, p<0.001), when the victim was a stranger (55.1% v. 38.8%, p<0.001), or when the victim was an unkempt individual (47.9% v. 28.5%, p<0.001). When asked to describe an OHCA, 41.4% said the heart stopped beating, and 20.8% said it was a heart attack. Identified barriers and facilitators included fear of litigation and lack of skill confidence.ConclusionsThis study identified gaps in knowledge, which may impair the ability of bystanders to act in OHCA. Most respondents expressed greater willingness to provide chest-compression-only CPR, but this was mediated by victim characteristics, skill confidence, and recognition of a cardiac arrest.

Mapping the public first‐aid training landscape: a scoping review

“…Even among trained participants, the proportion was only around 5 per cent (Brooks et al, 2015). Moreover, Cheskes et al (2016) report that participants provided a range of 24 different responses when asked for the proper CPR ratio.…”

“…As with training, age and employment status were also found to influence the willingness to help in an emergency: both higher age and unemployment are associated with a reduced inclination to help (Rasmus and Czekajlo, 2000;Kuramoto et al, 2008). Finally, other studies highlight that the type of CPR influences the level of willingness to help in an emergency; specifically, fewer people (~40 per cent) exhibit a willingness to perform traditional CPR, which includes mouth-to-mouth ventilation, than chest-only CPR (~60 per cent) (Lester, Donnelly, and Assar, 2000;Cheskes et al, 2016). In investigating variations across different first aid skills, Penrose (2009) identifies lower confidence and willingness to help for CPR (39 and 68 per cent, respectively) than for bleeding control first aid (60 and 78 per cent, respectively).…”

“…Confidence and the willingness to help in an emergency were also higher among respondents who were more educated or who had received more recent or more frequent first-aid training, as well as among male respondents (Donohoe, Haefeli, and Moore, 2006;Dwyer, 2008;Nielsen et al, 2013). Finally, other studies highlight that the type of CPR influences the level of willingness to help in an emergency; specifically, fewer people (~40 per cent) exhibit a willingness to perform traditional CPR, which includes mouth-to-mouth ventilation, than chest-only CPR (~60 per cent) (Lester, Donnelly, and Assar, 2000;Cheskes et al, 2016). Finally, other studies highlight that the type of CPR influences the level of willingness to help in an emergency; specifically, fewer people (~40 per cent) exhibit a willingness to perform traditional CPR, which includes mouth-to-mouth ventilation, than chest-only CPR (~60 per cent) (Lester, Donnelly, and Assar, 2000;Cheskes et al, 2016).…”

“…One study that compares bleeding control and CPR reveals that while most respondents had a good understanding of bleeding control (87 per cent), few were as familiar with CPR (21 per cent) (Penrose, 2009). Moreover, Cheskes et al (2016) report that participants provided a range of 24 different responses when asked for the proper CPR ratio. The proportion of respondents who were able to identify the correct compression-to-ventilation ratio, for example, was below 5 per cent in most studies (Rasmus and Czekajlo, 2000;Rajapakse, Noc, and Kersnik, 2010).…”

Community involvement in out of hospital cardiac arrest

“…In Lebanon, OHCA survival to hospital discharge was 5.5% with a shockingly low bystander-CPR rate of 4.2% [7] . Barriers to performing bystander CPR in more developed countries include deficient knowledge or training, lack of skill confidence, and fear or litigation [10] . Assessment of the awareness and knowledge of students in Lebanon with regard to cardiac arrest and CPR/AED use is lacking.…”