Abstract 45: Medically Educated Bystanders Start CPR Faster than Laypersons and Triple Survival Rates Compared with When No CPR Is Given in OHCA

Abstract

Background: There has been criticism raised against the value of CPR, whether the result of CPR education merely represents a more awareness of the critical situation thus initiating a more prompt call to dispatching centre and earlier start of CPR, rather than the fact that CPR are given. Aims: To explore different time frames in regards to whether the bystander is Lay persons or Medical educated, and to compare outcome between the two groups of bystanders. Methods: All patients in the Swedish Cardiac Arrest Registry who had a bystander witnessed out-of-hospital cardiac arrest between 1990 and 2010. This survey was divided into three groups: “No bystander CPR”, “Lay person bystander CPR” and “Medical educated bystander CPR”. Results: In all 28 888 patients were included and information on delays from collapse to call and start of CPR was available in 80 %. The mean age was highest (76 years) in the “No CPR” group. Cardiac arrest occurred at home more often (73%) in the “No CPR” and “Lay person” (62%) compared to the “Medical educated” group (33%). There were no differences between the groups in regards to delay from collapse to call (median 3 minutes in all). The median delay between collapse and start of CPR was 12 minutes in the “No CPR” , 6 minutes in the “Lay person” and after 3 minutes in the “Medical educated” group. Survival to 1 month was 4.0% (“No CPR”), 8.4% (“Lay person”) and 13.2% in the “Medical educated” group. Adjusted Odds Ratio (OR) for survival (“lay person” versus “No CPR”) was 2.49 [CI:2.13-2.92]. The corresponding figure for “Medical educated group” versus “No CPR” was 2.84 [2.35-3.44]. Adjusted OR (“Medical educated group” versus “Lay person”) was 1.18 [0.98-1.41]. Conclusions: Bystander CPR was associated with an increase in survival to one month regardless whether it was performed by Medical educated persons or Lay persons. Medical educated persons started CPR more rapidly than Lay persons. When adjusting for confounders CPR given by Medical educated persons did not significantly differ from CPR given by Lay persons in terms of survival to one month.