Quality and efficiency of bystander CPR

• Published in: Resuscitation Vol. 26; no. 1; pp. 47 - 52
• Main Authors: Van Hoeyweghen, Raf J, Bossaert, Leo L, Mullie, Arsene, Calle, Paul, Martens, Patrick, Buylaert, Walter A, Delooz, Herman
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.08.1993; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; bystander; Cardiac arrest; CPR; Emergency and intensive care: techniques, logistics; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Medical sciences; Outcome; CPR; bystander; Outcome; Cardiac arrest; Human; Professional qualification; Intensive cardiocirculatory care; Cardiocirculatory arrest; Correlation; Prehospital period; Heart disease; First emergency care; Cardiovascular disease; Statistical study; Survival
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/0300-9572(93)90162-J

Incorrectly performed bystander CPR might compromise survival of the cardiac arrest patient. We therefore evaluated the outcome in 3306 out-of-hospital primary cardiac arrests of which 885 received bystander CPR. bystanders performed CPR correctly in 52%, incorrectly in 11%, 31% performed only external chest compressions (ECC) and 6% only mouth-to-mouth ventilation (MMV). The initial ECG in cases without bystander CPR was ventricular fibrillation in 28% (95% confidence interval: 27–30%); 45% (41–50%) and 39% (29–48%), respectively when bystander CPR was performed correctly or incorrectly; 43% (37–49%) when only ECC was applied and 22% (11–33%) when only MMV was practiced. Long term survival, defined as being awake 14 days after CPR, was 16% (13–19%) in patients with correct bystander CPR; 10% (7–14%) and 2% (0–9%), respectively when only ECC or only MMV was performed; 7% (6–8%) when no bystander was involved; 4% (0–8%) when bystander CPR was performed incorrectly. Bystander CPR might have a beneficial effect on survival by maintaining the heart in ventricular fibrillation by ECC. A negative effect of badly performed bystander CPR was not observed compared to cases which had not received bystander CPR.