Targeting CPR education in high-risk neighborhoods could increase the
number of bystanders giving CPR and decrease deaths from cardiac
arrest, according to a new American Heart Association scientific
statement published in its journal
Circulation.
Survival rates for out-of-hospital cardiac arrest vary widely in
the United States, from 0.2 percent in Detroit, Mich., to 16 percent in
Seattle, Wash. The variance is due in part to whether a bystander does
CPR. For every 30 bystanders who do, one life is saved, researchers
said.
Yet according to the American Heart Association, bystanders
provide CPR only 40 percent of the time — and rates vary widely by
location.
The new statement calls for communities to determine which
neighborhoods have a high incidence of out-of-hospital cardiac arrests
and low rates of bystander CPR by using geographic information systems
that map the latitude and longitude of each cardiac arrest. Then, they
should focus public education efforts in the high-risk neighborhoods.
"We have always had a one-size-fits-all approach, blanketing a
whole area with CPR training, and we assume that will get to everyone,"
said Comilla Sasson, M.D., M.S., the statement's lead author and
assistant professor in the Department of Emergency Medicine at the
University of Colorado Anschutz Medical Campus in Denver.
"We are now saying that we need to shift our thinking to target CPR training to the areas where it is most needed."
"You have to have that kind of data to understand there are going
to be specific areas that need to be targeted to increase awareness of
cardiac arrest symptoms and how to do bystander CPR," Sasson said.
Such data can engage community members — motivating them to learn hands-only CPR, she said.
Better geographic data can also help researchers learn more about
why most bystanders don't perform CPR or call 9-1-1. Some people,
unaware of laws that protect them, worry they will be sued if they do
CPR wrong and cause harm.
"Most people don't know what a Good Samaritan law is," Sasson
said. Others fear they or household members will have to show
immigration papers before they can get help. And barriers to CPR
training can be as simple as when and where the training is held, Sasson
said.
Furthermore, charting addresses of everyone who receives CPR
training can provide useful information, she said. "Are we hitting the
same people who have always been trained and not really impacting these
higher-risk neighborhoods?"
Predominantly African-American or Hispanic neighborhoods have
higher rates of out-of-hospital cardiac arrest but lower rates of
bystander CPR compared with whites, research shows.
Bystander CPR is also less likely to happen in low-income neighborhoods, independent of race, Sasson said.
The statement also recommends a standardized dispatcher-assisted
telephone program for 9-1-1 operators to provide CPR instructions to
willing bystanders.
The survival rate from cardiac arrest — 9.5 percent — has been roughly
the same for three decades. To increase it, new strategies to promote
CPR are needed, Sasson said. "If we keep training the same people, we're
not going to make a difference."
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Co-authors are Hendrika Meischke, Ph.D.; Benjamin S. Abella, M.D.,
M.P.H.; Frederick Masoudi, M.D., M.P.H.; Michael R. Sayre, M.D.; Robert
A. Berg, M.D.; Bentley J. Bobrow, M.D.; Marcus Ong, M.D.; Elisabeth
Dowling Root, Ph.D.; Paul S. Chan, M.D., M.Sc.; Michele Heisler, M.D.,
M.P.H.; Jerrold H. Levy, M.D.; Mark Link, M.D.; John S. Rumsfeld, M.D.,
Ph.D.; and Thomas D. Rea, M.D., M.P.H. Author disclosures and sources of
funding are on the manuscript.
The American Heart Association's Hands-Only™ CPR campaign uses
entertainment and humor to deliver serious, lifesaving messages through
TV and radio public service announcements, digital promotions, a
one-minute animated "how to" video and a multi-city mobile CPR training
tour. To learn more about the Hands-Only
CPR campaign and tour, visit
heart.org/HandsOnlyCPR,
facebook.com/AHACPR or
youtube.com/HandsOnlyCPR. Read the association's 2008 scientific statement recommending Hands-Only CPR.
Follow @HeartNews on Twitter for the latest heart and stroke news.
Statements and conclusions of study authors published in American
Heart Association scientific journals are solely those of the study
authors and do not necessarily reflect the association's policy or
position. The association makes no representation or guarantee as to
their accuracy or reliability. The association receives funding
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influencing the science content. Revenues from pharmaceutical and
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