Ayal Pierce, MD
Resident Physician
George Washington University Hospital
Washington, District of Columbia
Disclosure information not submitted.
Ivy Benjenk, RN, MPH, PhD
Research Coordinator
George Washington University Hospital, United States
Disclosure information not submitted.
Yasir Hussein
George Washigton University
Washington, District of Columbia
Disclosure information not submitted.
David Yamane, BS, MD
Assistant Professor of Emergency Medicine, Anesthesiology, and Critical Care Medicine
George Washington University Hospital, United States
Disclosure information not submitted.
Natalie Sullivan, MD
Fellow in Disaster/Operational Medicine
George Washington University Hospital, United States
Disclosure information not submitted.
Title: Bystander CPR in the Nation’s capital. How does it measure up?
Introduction:
Bystander CPR is a significant predictor of outcomes in cardiac arrest. According to the 2018 report by the Cardiac Arrest Registry to Enhance Survival (CARES) database, the average rate of bystander CPR in cases of witnessed cardiac arrest in the United States (US) is 47%. Previous studies across the US and abroad have demonstrated the rate of bystander CPR is affected by specific geographic areas, urban versus rural settings, socioeconomic status, and demographics. Washington, D.C. is a highly diverse area with significant disparity in socioeconomic status and demographics by zip code. To date, there is no data regarding the rate of bystander CPR in such a diverse population. We hypothesized that bystander CPR would be lower in lower income neighborhoods with predominantly African American residents in the District of Columbia.
Methods:
We performed a retrospective analysis of the CARES database to assess the rate of bystander CPR in Washington, D.C. and geographically mapped the incidence of bystander CPR in the city by zip code between March 2014 and September of 2019. We analyzed differences in witnessed bystander CPR between ethnicities. Rates of bystander CPR by zip code were also analyzed.
Results:
A total of 3,466 cardiac arrests were captured in the database. 30% of witnessed cardiac arrests had bystander CPR. 13% of witnessed arrests were White. White patients were significantly more likely to receive bystander CPR than African Americans (44.83% vs 27.81% p < 0.001) and Hispanics (44.83% vs 22.22% p < 0.001). There were significantly higher rates of bystander CPR in zip codes where >45% of residents were White (35%) compared to zip codes where 15-45% of residents were White (26.7%) and zip codes where < 15% of residents were White (27.5%) (p=0.004).
Conclusions:
The overall rate of bystander CPR in Washington, D.C. is below the national average. White patients were significantly more likely to receive bystander CPR than African Americans and Hispanics. Additionally, zip codes with higher proportions of White residents had higher rates of bystander CPR. Further research and outreach efforts are needed to improve bystander CPR in Washington, D.C. with an emphasis on African American and Hispanic communities.