Yasir Hussein
George Washigton University
Washington, District of Columbia
Disclosure information not submitted.
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.
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: Who’s Coming to the Rescue? Lay person versus medical trained bystander CPR in our Nation’s Capital
Introduction: Immediate bystander CPR can significantly improve chances of survival in out-of-hospital cardiac arrest, but socioeconomic status, race, and urban environments lead to disparities in bystander CPR rates. While it is known that disparity populations have lower rates of bystander CPR, we do not currently know if there are differences in who is performing bystander CPR, lay people vs. medically trained bystanders. This analysis aims to identify if there are disparities in the comfort of non-medical lay persons in performing bystander CPR.
Methods: We performed a retrospective analysis of the Cardiac Arrests Registry to Enhance Survival (CARES) database to assess the rates of lay-person bystander CPR compared to rates of medically trained but off-duty bystander CPR. We defined lay person as an individual with no medical background and medical bystander as an individual with a medical background, but not on duty during time of witnessed arrest. We performed a t-test and logistic regression to determine the differences in lay person bystander CPR between race and between neighborhood demographics in Washington, DC.
Results: Between March 2014 and September 2019, 1,525 cases of witnessed cardiac arrest were captured by the database. Of these cases, 460 had lay person led bystander CPR with 121 (26.5%) of these bystanders having medical training but were off-duty. Compared to White patients, Black patients received less lay person CPR compared to medically trained but off duty CPR (12.09% vs 30.75%; p < 0.001). Similarly, there is less lay person bystander CPR in zip codes that contain less Caucasian population. Zip codes with > 45% white population had a rate of 81.77% lay person CPR compared to those with 15-45% white at a rate of 70.73% (p.= 0.024) or those zip codes with < 15% white population at 65.10% (p=0.001).
Conclusions: We found that when black residents and residents in low white percentage zip codes received bystander CPR it was less likely to be performed by a lay person. This highlights disparities in CPR proficiency and comfort. In order to increase survivability, all adults need to feel comfortable and empowered to perform CPR.