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

Abstract

Aims -To investigate whether the bystander-patient relationship affects bystander response to out-of-hospital cardiac arrest (OHCA) and patient outcomes depending on the time of day. Results-The rates of dispatcher-assisted CPR during daytime (7:00-18:59) and nighttime (19:00-6:59) were highest in family members (45.6% and 46.1%, respectively, for family members; 28.7% and 29.2%, respectively, for friends/colleagues; and 28.1% and 25.3%, respectively, for others). However, the BCPR rates were lowest in family members (35.5% and 37.8%, respectively, for family members; 43.7% and 37.8%, respectively, for friends/colleagues; and 59.3% and 50.0%, respectively, for others). Large delays (≥5 min) in placing emergency calls and initiating BCPR were most frequent in family members. The overall survival rate was lowest (2.7%) for family members and highest (9.1%) for friends/colleagues during daytime. Logistic regression analysis revealed that the effect of bystander relationship on survival 3 was significant only during daytime [adjusted odds ratios (95% CI) for survival from daytime OHCAs with family as reference were 1.51 (1.36-1.68) for friends/colleagues and 1.23 (1.13-1.34) for others]. Methods-ThisConclusions-Family members are least likely to perform BCPR and OHCAs witnessed by family members are least likely to survive during daytime. Different strategies are required for family-witnessed OHCAs.

Impact of Bystander Cardiopulmonary Resuscitation and Dispatcher Assistance on Survival After Out-of-Hospital Cardiac Arrest Among Adult Patients by Location of Arrest

“…10) Importantly, about twothirds of OHCAs occurred in residential locations, 22,23) and bystanders during OHCA in residential locations were more likely to be elderly family members. 24) They were less likely to have received CPR training and generally had little understanding of CPR, 25) which could be one reason that bystander-CPR-with-DA and no-bystander-CPR were higher in residential locations. DA initiation for family bystanders is often difficult because they tend to panic.…”

Senior citizens as rescuers: Is reduced knowledge the reason for omitted lay-resuscitation-attempts? Results from a representative survey with 2004 interviews

“…It is known that the majority of cardiac arrests occur in the home setting [14] and are mostly observed by laypersons, who are usually relatives of the patient [15]. Surprisingly, the probability of a resuscitation being initiated by a relative is lower than in other groups of individuals [16, 17]. The rate of resuscitations performed by a bystander [18, 19] and the likelihood of survival [20,21] are lower in the domestic setting than in other cases of cardiac arrest.…”

The daily incidence of out-of-hospital cardiac arrest unexpectedly increases around New Year's Day in Japan

“…Accordingly, several studies have investigated the extent to which the chances of resuscitation and survival vary over different conditions [6][7][8][9][10] including the types of symptoms, treatment provided [11][12][13] , patients' attributes 14,15 and situations 5,[16][17][18][19][20] . These previous studies have mostly utilized monthly observations of OHCA cases that had already occurred to investigate outcomes in relation to emergency care procedures.…”