Does the number of rescuers affect the survival rate from out-of-hospital cardiac arrests? Two or more rescuers are not always better than one

Abstract

Review: An increased number of rescuers may improve the survival rate from out-of-hospital cardiac arrests (OHCAs). The majority of OHCAs occur at home and are handled by family members.Materials and Methods: Data from 5,078 OHCAs that were witnessed by citizens and unwitnessed by citizens or emergency medical technicians from January 2004 to March 2010 were prospectively collected. The number of rescuers was identified in 4,338OHCAs and was classified into two (single rescuer (N=2,468) and multiple rescuers (N=1870)) or three (single rescuer, two rescuers (N=887) and three or more rescuers (N=983)) groups. The backgrounds, characteristics and outcomes of OHCAs were compared between the two groups and among the three groups.Results: When all OHCAs were collectively analysed, an increased number of rescuers was associated with better outcomes (one-year survival and one-year survival with favourable neurological outcomes were 3.1% and 1.9% for single rescuers, 4.1% and 2.0% for two rescuers, and 6.0% and 4.6% for three or more rescuers, respectively, (p=0.0006 and p<0.0001)). A multiple logistic regression analysis showed that the presence of multiple rescuers is an independent factor that is associated with one-year survival (odds ratio (95% confidence interval): 1.539 (1.088-2.183)). When only OHCAs that occurred at home were analysed (N=2902), the OHCAs that were handled by multiple rescuers were associated with higher incidences of bystander CPR but were not associated with better outcomes.Conclusions: In summary, an increased number of rescuers improves the outcomes of OHCAs. However, this beneficial effect is absent in OHCAs that occur at home. Word count 250

Factors associated with quality of bystander CPR: The presence of multiple rescuers and bystander-initiated CPR without instruction

“…In our previous study [17], the presence of multiple rescuers was associated with improved 1-Y survival after OHCAs; similarly, in the present study, the presence of multiple rescuers was independently associated with good-quality BCPR. Presumably, the presence of multiple bystanders increases the chances of bystander initiative from individuals who are able to provide good-quality CPR.…”

“…The time points of arrest recognition/witness and BCPR initiation were estimated by the EMTs by interviewing bystanders, as previously described [16]. Bystanders' relationship to the OHCA patient, bystander's age and gender of bystanders, bystanders' BLS training experience and total number of rescuers were also identified by the EMTs by interviewing bystanders, as previously described [17]. The time of dispatch-assisted initiation of BCPR following DA-CPR was identified by dispatch records.…”

Potential association of bystander–patient relationship with bystander response and patient survival in daytime out-of-hospital cardiac arrest

“…These data and the results of analysis for supplementary data in Ishikawa Prefecture (Supplementary Table 1) indicate that older family members, mostly aged couples are left at home during daytime. Because placing an emergency call is frequently delayed [19] and multiple rescuers are rarely present [21] at home, this environment may be more isolated from the emergency medical service system during daytime. Large questionnaire surveys have shown that elderly citizens are more reluctant to attend BLS courses [22] and perform BLS [23].…”

Public Knowledge and Attitudes towards Bystander Cardiopulmonary Resuscitation in China

“…Survival from sudden cardiac arrest in China is much lower than in many countries. Immediate bystander cardiopulmonary resuscitation (CPR) increases out-of-hospital cardiac arrest (OHCA) survival by twofold to threefold [5–7]. The chance of surviving OHCA falls by 7%–10% per minute without intervention [8].…”