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CPR Educators Concerned over Bystander Reluctance
PRESS RELEASE
To maximize the likelihood of out-of-hospital cardiac arrest (OHCA) survival, strong EMS systems rely on collaboration between lay responders and EMS. The loss of bystander willingness to perform CPR due to COVID-19 presents a concerning situation for already low OHCA survival rates. Important adjustments are needed to restore public willingness to attempt CPR.
The COVID-19 pandemic is having far-reaching implications on the way bystanders respond to out-of-hospital cardiac arrest. A new survey conducted by researchers at Avive indicates overwhelming concern by CPR instructors that fear of COVID-19 has increased bystander reluctance to perform life-saving interventions on OHCA victims.
The study, which involved an online survey of 337 CPR educators, found that 40% of respondents hold strong concern about the reluctance of bystanders to intervene while 34% hold moderate concern. The instructors surveyed also reported a decline in the number of people seeking CPR training since the pandemic began. 73% of instructors said that they are training fewer students. Of those instructors, 52% have lost over half of their pre-COVID-19 volumes. 9% of all respondents have stopped teaching CPR due to COVID-19.
Bystander action, involving immediate CPR and defibrillation, is critical for improving historically low OHCA survival rates. Bystander hesitation jeopardizes these crucial links in the chain of survival.
Other recent data have shown a marked decline in the number of OHCA patients who receive bystander CPR in 2020, compared to pre-pandemic times. In Paris, for example, bystander CPR in 2020 stood at 47.8% compared to 63.9% between 2012 and 2019. Further, OHCA appears to be on the rise. Data from New York show that the incidence of non-traumatic OHCA was 3 times higher in 2020 than during the same period in 2019. There is also a connection between COVID-19 and cardiac arrest, with COVID-19 increasing risk of OHCA due to secondary effects of the virus and treatment.
The intersection of significantly reduced training volume, bystander inaction, and increasing cardiac arrest prevalence presents a deeply concerning situation for OHCA survival rates. Layperson reluctance to both learn and perform CPR places an added burden on EMS systems. Additionally, without early bystander recognition, CPR, and defibrillation, the pre-EMS links in the chain of survival are broken—indicating that fewer OHCA patients will survive after EMS arrival.
Aside from being exposed to COVID-19 at a disproportionately higher rate, hesitation by bystanders to offer help eliminates a crucial support layer that EMS needs to increase the likelihood of successful resuscitation.
Appropriate action to restore public interest in CPR needs to be instituted. These include increased training, provision of PPE, and encouraging hands-only CPR.
The full report can be found here.
Avive Solutions Inc. is a San Francisco-based privately held healthcare technology company developing a next-generation automated external defibrillator alongside a first-of-its-kind platform solution to revolutionize cardiac arrest response to significantly increase survival rates from sudden cardiac arrest.
