141 Availability and Quality of Cardiopulmonary Resuscitation Information for Spanish-Speaking Population on the Internet

Abstract

Bystander cardiopulmonary resuscitation (CPR) is a vital step in the care of out-of-hospital cardiac arrests (OHCA). Hands-only CPR has been shown to have increased survival compared to conventional CPR and no bystander CPR. Self-education though Internet resources has become widespread in the United States, and has been used to teach bystander CPR. However, disparity exists on who receives CPR, with Hispanics having a bystander CPR rate of only 32%. This is an important public health concern as Hispanics account for 14.8% of the U.S. population, 44.3 million Americans, with a 24% growth rate between 2000 and 2006. As such, public education, through the use of the Internet, may be critical in improving the rate of bystander CPR in this population. To evaluate the availability and quality of CPR-related literature for Spanish-speaking individuals on the Internet. The most popular search engines (Google and Yahoo!) and video-site (Youtube) were searched from March 7 to April 1, 2011 using the following terms: “resucitación cardiopulmonar” and “reanimación cardiopulmonar.” Web sites were included if they demonstrated adult CPR technique in Spanish. Web sites were excluded if they demonstrated pediatric CPR technique and/or did not educate on how to perform CPR. Data elements collected were Web site creator, target audience, use of video, type of CPR education and quality of CPR education. To assess quality, Web sites were scored on key aspects of CPR education, namely how to assess scene safety, verify responsiveness, activate EMS or call 911, position hands on chest, and perform accurate rate and depth of compressions. The initial search resulted in 424 Web sites, of which 116 Web sites met criteria for inclusion. The majority of Web sites (86.2%) educated viewers on traditional bystander CPR (primarily, 30:2 CPR with alternating compressions and ventilations), 13.8% taught hands-only CPR technique. Majority of Web sites were created by health care-associated persons or organizations (64.7%), created outside of the United States (75.9%), and targeted a lay audience (62.1%). Of Web sites that used video (N=62), 83.9% were conducted in Spanish, 16.1% in English. The quality of CPR education was generally poor (mean score of 2.4, interquartile range of 3). Education on assessing scene safety was the most missed category, with 88.0% of Web sites failing this category. Only half of Web sites properly educated on how to check responsiveness, activate EMS and position hands on chest. Majority of Web sites had improper or no education on both rate and depth of compressions (58.6% and 62.9%, respectively). Only 15.5% of Web sites hit >5 quality markers for proper hands-only bystander CPR. The vast majority of Web sites for Spanish-speaking people do not teach hands-only bystander CPR, despite 2010 American Heart Association recommendations. Only 1 in 7 Web sites found on the Internet has quality CPR education for this population. This suggests that more emphasis should be placed on 1) improving the quality of educational resources available on the Internet for Spanish-speaking populations, and 2) including more information on hands-only CPR. These steps will be imperative in improving the dismal rate of bystander CPR in Hispanic communities.