Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services

Riva, Gabriel; Ringh, Mattias; Jönsson, Martin; Svensson, Leif; Herlitz, Johan; Claesson, Andreas; Djärv, Therese; Nordberg, Per; Forsberg, Sune; Rubertsson, Sten; Nord, Anette; Rosenqvist, Mårten; Hollenberg, Jacob

doi:10.1161/circulationaha.118.038179

Cited by 119 publications

(89 citation statements)

References 162 publications

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“…These may include: poverty, poor diet (potentially leading to obesity and diabetes), higher incidence of smoking and higher rates of mental illness. [4][5][6][7] Bystander Cardiopulmonary Resuscitation (BCPR) can double the chance of survival from OHCA [8], yet it is performed less often in deprived communities. Findings from Scotland indicate that people living in deprived areas are both more likely to have a cardiac arrest and more likely to have a cardiac arrest earlier in comparison to individuals living in less deprived areas.…”

Section: Introductionmentioning

confidence: 99%

Barriers to bystander CPR in deprived communities: Findings from a qualitative study

et al. 2020

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Study aim Rates of out of hospital cardiac arrest are higher in deprived communities. Bystander Cardiopulmonary Resuscitation (BCPR) can double the chance of survival but occurs less often in these communities in comparison to more affluent communities. People living in deprived communities are, therefore, doubly disadvantaged and there is limited evidence to explain why BCPR rates are lower. The aim of this paper is to examine the barriers to administering BCPR in deprived communities. Method Mixed method qualitative study with ten single sex focus groups (n = 61) conducted in deprived communities across central Scotland and 18 semi-structured interviews with stakeholders from the UK, Europe and the USA. Results Two key themes related to confidence and environmental factors were identified to summarise the perceived barriers to administering BCPR in deprived communities. Barriers related to confidence included: self-efficacy; knowledge and awareness of how, and when, to administer CPR; accessing CPR training; having previous experience of administering BCPR; who required CPR; and whether the bystander was physically fit to give CPR. Environmental barriers focused on the safety of the physical environment in which people lived, and fear of reprisal from gangs or the police. Conclusions Barriers to administering BCPR identified in the general population are relevant to people living in deprived communities but are exacerbated by a range of contextual, individual and

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Section: Introductionmentioning

confidence: 99%

Barriers to bystander CPR in deprived communities: Findings from a qualitative study

et al. 2020

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“…Recently Riva et al found there was an almost a 2-fold higher rate of CPR before EMS arrival and a concomitant 6-fold higher rate of CO-CPR over time but did not collect neurological outcome at day 30. 25 Lay bystanders are more and more often performing CO-CPR From 2013 to 2017, we observed a clear decrease in S-CPR by lay bystanders to the bene t of CO-CPR (reduction of 50%). The same trends were observed in Sweden during the same period, 25 and it has also been observed in other countries.…”

Section: Discussionmentioning

confidence: 72%

“…25 Lay bystanders are more and more often performing CO-CPR From 2013 to 2017, we observed a clear decrease in S-CPR by lay bystanders to the bene t of CO-CPR (reduction of 50%). The same trends were observed in Sweden during the same period, 25 and it has also been observed in other countries. 11,15,16 Indeed, since 2010, the International Consensus on Cardiopulmonary Resuscitation has been encouraging untrained people to carry out CO-CPR, and EMS dispatchers must provide CO-CPR instructions by telephone.…”

Section: Discussionmentioning

confidence: 72%

Neurological Outcome of Chest Compression-Only Bystander CPR in Asphyxial and Non-Asphyxial Out-of-Hospital Cardiac Arrest: An Observational Study

Javaudin

Raiffort

Desce

et al. 2020

Preprint

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Background: According to guidelines and bystander skill, two different methods of cardiopulmonary resuscitation (CPR) are feasible: standard CPR (S-CPR) with mouth-to-mouth ventilations and chest compression-only CPR (CO-CPR) without rescue breathing. CO-CPR appears to be most effective for cardiac causes, but there is a lack of evidence for asphyxial causes of out-of-hospital cardiac arrest (OHCA). Thus, the aim of our study was to compare CO-CPR versus S-CPR in adult OHCA from medical etiologies and assess neurologic outcome in asphyxial and non-asphyxial causes.Methods: Using the French National OHCA Registry (RéAC), we performed a multicenter retrospective study over a five-year period (2013 to 2017). All adult-witnessed OHCA who had benefited from either S-CPR or CO-CPR by bystanders were included. Non-medical causes as well as professional rescuers as witnesses were excluded. The primary end point was 30-day neurological outcome in a weighted population for all medical causes, and then for asphyxial, non-asphyxial and cardiac causes. Results: Of the 8 619 subjects included for all medical causes, 6 742 had a non-asphyxial etiology, including 5 904 of cardiac causes, and 1 710 had an asphyxial OHCA. 8.6%; 95% CI [8.1-9.3] of subjects had a good neurological outcome (i.e. cerebral performance category of 1 or 2). Bystanders who performed S-CPR began more often immediately (89.0%; 95% CI [87.3-90.5] versus 78.2%; 95% CI [77.2-79.2]) and in younger subjects (64.1 years versus 65.7; p < 0.001). In the weighted population, subjects receiving bystander-initiated CO-CPR had an adjusted relative risk (aRR) of 1.04; 95% CI [0.79-1.38] of having a good neurological outcome at 30 days for all medical causes, 1.28; 95% CI [0.92-1.77] for asphyxial etiologies, 1.08; 95% CI [0.80-1.46] for non-asphyxial etiologies and 1.09; 95% CI [0.93-1.28] for cardiac-related OHCA.Conclusions: We observed no significant difference in neurological outcome when lay bystanders of OHCA initiated CO-CPR or S-CPR, whether the cause was asphyxial or not. CO-CPR should probably be promoted in adults because it has many advantages (easier to learn and lower infection risk).

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“…Fatalerweise haben viele Ersthelfer dann nicht nur auf die Beatmung, sondern konsekutiv auch auf die Herzdruckmassage verzichtet. Die Reduktion auf die Herzdruckmassage und damit auf die 3 Schritte Prüfen.Rufen.Drücken kann diesem entgegenwirken und die Rate an Laienreanimationen signifikant steigern [32,33].…”

Section: Materials Und Methodenunclassified

Anstieg der Laienreanimationsrate in Deutschland geht mit vermehrter Telefonreanimation einher

Metelmann

Schneider

et al. 2019

Notarzt

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Zusammenfassung Ziel der Studie In der vergangenen Dekade wurden Initiativen zur Erhöhung der Laienreanimationsrate ergriffen. Ist die Rate in den letzten 10 Jahren gestiegen? Ist dies assoziiert mit Veränderungen der Leitstellenleistung? Methodik Analyse prähospitaler Daten des Deutschen Reanimationsregisters. Einschluss von Fällen aus 19 deutschen Standorten zwischen 2008 und 2017. Ausschluss von Herz-Kreislauf-Stillständen nach Eintreffen des Rettungsdienstes, in Arztpraxen oder Kliniken. Analyse mit Chi-Quadrat-Test und Clopper-Pearson-Konfidenzintervallen. Ergebnisse Analysiert wurden die Daten von 22 555 Patienten. Die Laienreanimationsrate stieg von 23,4% im Jahr 2008 (606 von 2591, 95%-KI: 21,8 – 25,1%) auf 36,9% im Jahr 2017 (1014 von 2749, 95%-KI: 35,1 – 38,7%) (p < 0,001). Gleichzeitig stieg die telefonische Anleitung von 0,4% (11 von 2591, 95%-KI: 0,2 – 0,8%) auf 24,3% (670 von 2749, 95%-KI: 22,8 – 26,0%) (p < 0,001). Schlussfolgerung Die Laienreanimationsrate stieg um mehr als 50% bei vermehrter Telefonreanimation und Laienschulung. Ein kausaler Zusammenhang lässt sich nicht belegen.

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Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services

Abstract: Survival after different forms of bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest THESIS FOR DOCTORAL DEGREE (Ph.D.

Cited by 119 publications

References 162 publications

Barriers to bystander CPR in deprived communities: Findings from a qualitative study

Barriers to bystander CPR in deprived communities: Findings from a qualitative study

Neurological Outcome of Chest Compression-Only Bystander CPR in Asphyxial and Non-Asphyxial Out-of-Hospital Cardiac Arrest: An Observational Study

Anstieg der Laienreanimationsrate in Deutschland geht mit vermehrter Telefonreanimation einher

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