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Potential impact upon community mortality rates of training citizens in cardiopulmonary resuscitation
C F Weston1, D W Hughes, M D Donnelly
1Institute for Health Promotion, University of Wales College of Medicine.
Insights
Community training in cardiopulmonary resuscitation (CPR) may offer modest cardiac mortality reductions. While potentially saving up to 56 lives per 100,000 annually, realistic impact suggests saving fewer than six lives per 100,000.
Area of Science:
- Public Health
- Emergency Medicine
- Cardiology
Background:
- Out-of-hospital cardiac arrest remains a significant cause of mortality.
- Community awareness and bystander intervention are crucial for improving survival rates.
- Cardiopulmonary resuscitation (CPR) training aims to increase bystander response during cardiac emergencies.
Purpose of the Study:
- To estimate the potential impact of a community-wide cardiopulmonary resuscitation (CPR) training program on cardiac mortality.
- To assess the effectiveness of bystander CPR in out-of-hospital cardiac arrest scenarios.
- To evaluate the realistic benefits of widespread CPR education in a defined population.
Main Methods:
- A review of all adult deaths in Cardiff (population 292,600) over a 13-week period.
- Identification of deaths due to out-of-hospital cardiac arrest from heart disease where CPR might have been beneficial.
- Analysis of witnessed arrests, bystander CPR initiation, and emergency service response times.
Main Results:
- Of 701 deaths, 70 were fatal out-of-hospital cardiac arrests.
- Only 48.6% of these arrests were witnessed, and CPR was not initiated in 22 witnessed cases.
- Immediate summoning of emergency services was often delayed.
Conclusions:
- Community CPR training programs may lead to a modest reduction in cardiac mortality, potentially saving 0.4% to 7.5% of lives.
- While individual program impact is limited, countrywide implementation could result in a significant total number of lives saved.
- Careful evaluation of community CPR training program implementation and outcomes is recommended.
Abstract:
In order to estimate the impact of a community programme of training in cardiopulmonary resuscitation (CPR), we reviewed all adult deaths in the city of Cardiff (population 292,600) during a 13-week period. Of 701 deaths, 70 were cases of fatal out-of-hospital cardiac arrest due to heart disease, for whom it was felt that CPR might have been of value. Only 34 (48.6%) deaths were witnessed, and in 22 of them the witness did not start CPR. In the majority of cases the ambulance service was not summoned immediately. We calculate that a community CPR training programme may, at best, reduce the community cardiac mortality rate by 7.5%, ie saving between 24 and 56 lives per 100,000 adult population per year; but more realistically, such a programme can only achieve a reduction of 0.4%, ie saving up to six lives per 100,000 per year. Although community CPR training programmes are likely to lead to only a modest reduction in community cardiac mortality rates, because countrywide there are many deaths, the total of lives saved would be significant. Implementation of such programmes should be carefully evaluated.