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  • Perspectives of emergency department attendees on outcomes of resuscitation efforts: origins and impact on cardiopulmonary resuscitation preference

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Original research
Perspectives of emergency department attendees on outcomes of resuscitation efforts: origins and impact on cardiopulmonary resuscitation preference
  1. Norkamari Shakira Bandolin1,
  2. Weixiao Huang2,
  3. Laurel Beckett3,
  4. Garen Wintemute1
  1. 1 Department of Emergency Medicine, University of California Davis, Sacramento, California, USA
  2. 2 Department of Statistics, University of California Davis, Sacramento, California, USA
  3. 3 Department of Public Services, University of California Davis, Sacramento, California, USA
  1. Correspondence to Dr Norkamari Shakira Bandolin, Department of Emergency Medicine, University of California Davis, Sacramento, CA 95817, USA; sbandolin{at}ucdavis.edu

Abstract

Background Previous studies have shown that individuals overestimate the success of cardiopulmonary resuscitation (CPR) while underestimating its morbidity. Although perceptions of CPR success affect medical care in the emergency department (ED), no ED-based studies have been done.

Objective To survey ED patients and their companions to assess their expectations, hypothesising that variation in information sources, prior exposure to CPR, and healthcare experience would influence predicted CPR success rates.

Methods A survey was carried out of adults (age >18 years) in the ED waiting area of a tertiary care hospital between June and September 2016. An optimism scale was created to reflect expected likelihood of survival after CPR, or CPR success, under several sets of circumstances. Potential predictors of optimism for CPR outcome were examined using linear regression. Associations between optimism and CPR preference were evaluated using a Wilcoxon rank-sum test.

Results There were 500 respondents and 53% had performed or witnessed CPR, and/or participated in a CPR course (64%). Television was the main source of information about CPR for >95% of respondents. At least half (51–64%) of respondents estimated the success rate of CPR as over 75% in all situations. Estimated CPR success rates were unrelated to age, sex, race, spiritual beliefs or personal healthcare experience. More than 90% of respondents wanted to receive CPR. Less than one-third of respondents had discussed CPR with a medical provider, but most wished to do so.

Conclusion Consistent with prior studies, individuals overestimate the success rate of CPR. Healthcare experience does not appear to mitigate optimism about CPR, and individuals overwhelmingly want CPR for themselves. Though few had talked about CPR with a medical provider, most wanted to have informed decision-making conversations. Such discussions could help patients obtain a more realistic view of CPR outcomes.

  • resuscitation
  • emergency department
  • cardiac arrest
  • death/mortality
  • education

https://doi.org/10.1136/emermed-2018-208084

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    Footnotes

    • Handling editor Kirsty Challen

    • Contributors This manuscript reflects an original prospective survey-based research project undertaken at the University of California Davis Emergency Department in 2016. NSB and GW were the primary investigators and created the survey, obtained institutional review board approval and facilitated data collection. Data were reviewed, cleaned and analysed by LB and WH with oversight by NSB and GW. All authors contributed to revising and final creation of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This original study was reviewed by the University of California Davis institutional review board located in Sacramento, California. The project and institutional review board approval number is 8 77 224-1.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Additional deidentified and completed surveys are available if needed.