The impact of bystander relation and medical training on out-of-hospital cardiac arrest outcomes

Haskins, Brian; Smith, Karen; Cameron, Peter; Bernard, Steve; Nehme, Ziad; Murphy-Smith, Jake; Metcalf, Matthew; Moussa, Rana; Harvey, D. Brandon; Turnbull, Lauren; Dyson, Kylie

doi:10.1016/j.resuscitation.2020.02.036

Cited by 15 publications

(9 citation statements)

References 32 publications

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“…However, rates of bystander CPR significantly increased and, although counterintuitive, it is understandable as people remained at home, often with others, during the pandemic period. We have also shown previously that the most likely person to perform CPR is a family member 17 . Resuscitation duration in non-survivors was significantly shorter in the pandemic period than in the non-pandemic comparator period.…”

Section: Discussionsupporting

confidence: 71%

Collateral damage: Hidden impact of the COVID-19 pandemic on the out-of-hospital cardiac arrest system-of-care

et al. 2020

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Aim: Out-of-hospital cardiac arrest (OHCA) during COVID-19 has been reported by countries with high case numbers and overwhelmed healthcare services. Imposed restrictions and treatment precautions may have also influenced OHCA processes-of-care. We investigated the impact of the COVID-19 pandemic period on incidence, characteristics, and survival from OHCA in Victoria, Australia. Methods: Using data from the Victorian Ambulance Cardiac Arrest Registry, we compared 380 adult OHCA patients who received resuscitation between 16th March 2020 and 12th May 2020, with 1218 cases occurring during the same dates in 2017À2019. No OHCA patients were COVID-19 positive. Arrest incidence, characteristics and survival rates were compared. Regression analysis was performed to understand the independent effect of the pandemic period on survival. Results: Incidence of OHCA did not differ during the pandemic period. However, initiation of resuscitation by Emergency Medical Services (EMS) significantly decreased (46.9% versus 40.6%, p = 0.001). Arrests in public locations decreased in the pandemic period (20.8% versus 10.0%; p < 0.001), as did initial shocks by public access defibrillation/first-responders (p = 0.037). EMS caseload decreased during the pandemic period, however, delays to key interventions (time-to-first defibrillation, time-to-first epinephrine) significantly increased. Survival-to-discharge decreased by 50% during the pandemic period (11.7% versus 6.1%; p = 0.002). Survivors per million person-years dropped in 2020, resulting in 35 excess deaths per million person-years. On adjusted analysis, the pandemic period remained associated with a 50% reduction in survival-to-discharge. Conclusion: The COVID-19 pandemic period did not influence OHCA incidence but appears to have disrupted the system-of-care in Australia. However, this could not completely explain reductions in survival.

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Section: Discussionsupporting

confidence: 71%

Collateral damage: Hidden impact of the COVID-19 pandemic on the out-of-hospital cardiac arrest system-of-care

et al. 2020

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“…The fear of harming an OHCA victim and the possible liabilities involved are the main reasons why bystanders would hesitate to perform AED. The consequence of this reluctance to help a victim who is a stranger is a poor OHCA survival rate [29,30]. This phenomenon is also seen in the performance of CPR, as CPR shares a similar characteristic to AED in saving OHCA victims.…”

Section: Discussionmentioning

confidence: 99%

Bystanders’ Views on the Use of Automated External Defibrillators for Out-of-Hospital Cardiac Arrest: Implications for Health Promotions

Chow

2021

IJERPH

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Despite the widespread availability of automated external defibrillators, not everyone is enthusiastic about using them. The aim of this study was to examine the reasons for not using an automated external defibrillator (AED) and predictors of the reasons. The study had a cross-sectional design using an online survey. Data were collected in eighteen districts in Hong Kong to be representative of the city. The questionnaire consisted of questions on demographics, knowledge and attitude towards AED use, reasons for not using AED, and whether the kind of victim could affect the decision of the bystanders. There was a high significant correlation between knowledge and attitude, with r = 0.782 and p < 0.001. Of the respondents, 53.3% agreed that the kind of victim would affect their willingness to operate an AED. A binary logistic regression model revealed that a higher education (OR 6.242, 95% CI: 1.827–21.331), concern about the kind of victim involved (OR 2.822, 95% CI: 1.316–6.052), and a younger age were significant predictors of worrying about taking on responsibility in using AED. Other than knowledge, other barriers included a desire to avoid legal liability, and the kind of victim they encountered. Life experiences in adulthood could possibly affect the social responsibility and influence the behaviors of adults to operate AEDs.

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“…The use of ‘apps’ for this dispatch allows the user to choose their availability for dispatch. These programs provide an excellent opportunity for HCPs to improve their local OHCA outcomes, especially as huge gains in survival are seen when bystander BLS is provided by off-duty HCPs [22], and to increase their exposure to resuscitation.…”

Section: Opportunities For Healthcare Professional To Improve Out-of-...mentioning

confidence: 99%

The future of resuscitation education

Bray

Greif

2022

Current Opinion in Critical Care

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Purpose of reviewThe purpose of this review is to provide an update for critical care clinicians and providers on the recent developments in patient and healthcare professional (HCP) resuscitation education. Recent findingsThe family members of patients at high-risk of cardiac arrest need to be provided with access to basic life support (BLS) training. Many low-cost methods are now available to provide BLS training beyond attending a traditional BLS instructor-led cardiopulmonary resuscitation (CPR) class. Hybrid-blended learning formats provide new opportunities to receive individualized CPR-training in a flexible and convenient format. HCPs' participation in accredited advanced life support courses improves patient outcomes. Monitoring HCPs exposure to resuscitation and supplementing with frequent simulation is recommended. Training should include human factors and nontechnical skills. Volunteering for first responder programs when off-duty provides a great opportunity for HCP's to improve out-of-hospital cardiac arrest survival and increase exposure to resuscitation. SummaryFrequent resuscitation education and training is critical to improving cardiac arrest patient outcomes. Recent evidence shows the effectiveness of technological developments to improve access to training and outcomes.

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The impact of bystander relation and medical training on out-of-hospital cardiac arrest outcomes

Cited by 15 publications

References 32 publications

Collateral damage: Hidden impact of the COVID-19 pandemic on the out-of-hospital cardiac arrest system-of-care

Collateral damage: Hidden impact of the COVID-19 pandemic on the out-of-hospital cardiac arrest system-of-care

Bystanders’ Views on the Use of Automated External Defibrillators for Out-of-Hospital Cardiac Arrest: Implications for Health Promotions

The future of resuscitation education

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