A Cross-Sectional Analysis of Bystander Cardiopulmonary Resuscitation (CPR): Behavioural Changes in the COVID-19 Era

Objectives The coronavirus disease 2019 (COVID-19) pandemic has impacted public health systems and individuals' behaviour, with decreasing survival rates among out-of-hospital cardiac arrest (OHCA) patients. Bystander cardiopulmonary resuscitation (CPR) improves OHCA outcomes, which may have been affected by COVID-19. We sought to understand the impacts of COVID-19 on bystanders' willingness to administer CPR in three Canadian provinces. Methods Participants ≥ 18 years of age were surveyed online about their current and recalled pre-pandemic attitudes toward CPR and perceived transmission risk. We compared mean willingness to perform various CPR actions before and during the pandemic using paired t-tests. Differences in willingness across three provinces were assessed using analysis of variance (ANOVA) and Tukey's Honestly Significant Difference (HSD) test. We also conducted Chi-square tests to assess changes in willingness to perform CPR on children and older adults. Results Five hundred thirty-five participants were surveyed from October 1 to November 15, 2021. The mean age was 42.7 years (SD 14.5), and 60.2% were female. Participants reported less willingness to perform chest compressions on strangers during the pandemic compared to their recollections before the pandemic (mean willingness 86.2% vs. 94.3% prior, p<0.001). With personal protective equipment (PPE) available, particularly masks, willingness recovered to 91.3% (p<0.001). Willingness was higher in Nova Scotia (NS) than in British Columbia (BC) or Ontario (ON). Reluctance to assist older adults increased from 6.6% to 12.0% (p=0.020). Conclusions This study highlights changes in CPR willingness during the COVID-19 pandemic, underscoring the importance of PPE and offering insights into public health strategies pertaining to CPR during a pandemic.