Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association

Abstract

Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.

Assessing the weak links – Necessity and impact of regional cardiac arrest awareness campaigns for laypersons

“…As such, cardiac awareness campaigns may focus on reaching as many people as possible to improve recognition of cardiac arrest and initiation of chest compressions by bystanders, who are assisted by dispatchers. 36 While dispatched AEDs through citizen first responders and police officers may be a more effective strategy to facilitate early defibrillation. 7 , 37 Tiered systems like this may resemble an actionable concept to make early high-quality resuscitation available to all.…”

Arrêt cardiaque chez une adolescente de 14 ans lors d’un séjour en camp de vacances

“…Le débreffage après un arrêt cardiaque survenu hors d’un centre hospitalier est important pour l’adaptation psychologique des témoins et des prestataires de soins; il est vital pour l’optimisation des performances du système 12 . Le médecin et le directeur du camp ont immédiatement débreffé les campeurs présents dans le chalet pendant l’intervention, et ont fourni une réponse appropriée à la crise afin de soutenir leur santé mentale.…”

Cardiac arrest in a 14-year-old at an overnight camp

“…Debriefing after an out-of-hospital cardiac arrest is important both for witnesses' and providers' psychological coping, and is vital for optimizing system performance. 12 The campers present in the cabin during the time of the arrest underwent an immediate debrief by the camp physician and a camp director, with an appropriate crisis response to support their mental health. Crisis counsellors were made available for camp counsellors and others over the ensuing days.…”