Legislative Status of Public-Access Cardiopulmonary Resuscitation - China, 2024

Public-access cardiopulmonary resuscitation (CPR) ranks first in the "Prevention and Control of Major Diseases" section of the Healthy China 2030 Initiative. However, Chinese patients who have experienced out-of-hospital cardiac arrest (OHCA) are reported to have a survival rate at discharge of only 0.35%. This study explored the necessity of CPR legislation in China by comparing CPR-related legislation among four major global economies: the USA, China, Germany, and Japan. We searched for national, provincial, and major urban regulations in China and analyzed indicators related to public-access CPR. All four countries have laws supporting life-saving out-of-hospital interventions. However, unlike the other three countries, no national laws in China mention CPR, defibrillators, or cardiac arrest. China has only 23 local regulations across 67 provincial regions or major cities and no national regulations on pre-hospital emergency care. Among these 23 existing regulations, only 4.3% mention cardiac arrest, 39.1% mention CPR, 73.9% mention defibrillators, and none mention telecommunicator CPR. Moreover, 17.4% of these regulations do not include any of the legislative points appearing in the national laws of the three comparator countries. The current legislative status concerning public-access CPR is inconsistent with the position on CPR outlined in the Healthy China 2030 Initiative. We recommend initiating and accelerating a specialized National Public-Access Cardiopulmonary Resuscitation Law for China.