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


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

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