Attitudes of trained Swedish lay rescuers toward CPR performance in an emergency.: A survey of 1012 recently trained CPR rescuers
Introduction
The importance of bystander cardiopulmonary resuscitation (CPR) is well documented in several studies [1], [2], [3], [4], [5]. Since 1973, the American Heart Association (AHA) has been recommending that CPR training programmes should be extended to include lay people [6]. Yet in 1997, the International Liaison Committee on Resuscitation (ILCOR) noted that most communities still do not train a sufficiently high proportion of the public to perform basic CPR and that the rates of community CPR in the USA and Europe had not increased substantially since the 1970s [7].
Ten years after the AHA recommendation, a national training programme was introduced in Sweden with the intention of teaching community citizens to perform CPR. In Sweden (population 8.8 million), there are currently some 1.5 million trained CPR rescuers. The intention of the Swedish national training programme was not only to teach the techniques of CPR but also to motivate the citizens to initiate CPR as well [8]. Sweden’s out-of-hospital cardiac arrest incidence averages 10 000 a year. About 60% of cardiac arrests outside hospital are witnessed by bystanders and CPR is initiated prior to emergency medical service (EMS) arrival in ≈30% [9]. In the event of sudden death, CPR must be initiated promptly and without hesitation and the EMS systems therefore have to rely on trained bystanders (professionals or lay people). When the emergency personnel arrive, it is most frequently too late.
With an ongoing massive CPR training programme in the community, it is interesting to investigate whether trained lay people are willing to use their skills. The purpose of this study was to analyse recently trained CPR rescuers’ attitudes and beliefs in terms of CPR performance in an actual emergency and to investigate differences in attitudes and beliefs with regard to gender, age, residential area and occupation. Owing to the unique registration of trained CPR rescuers in Sweden, it was possible to conduct a nation-wide study, the first one available in literature.
Section snippets
Target area
The country of Sweden with 8.8 million inhabitants.
Target population
Adult persons who had received training in basic CPR in January 1997.
Sample
The CPR centre in Sweden keeps a computer register of all basic and advanced instructors trained in Swedish Society of Cardiology courses all over Sweden. All certified CPR rescuers are reported to this centre by their instructors.
The group which was eligible for this study comprised of 3116 adults reported as having trained in basic CPR in January 1997. Everyone aged 18 and
Participants
We received 1012 valid questionnaires from 433 males and 579 females. The respondents were distributed between 316 instructors, making an average of 3.2±2.2 respondents for each instructor. The mean age was 35.5 years for males and 38.0 years for females and only 3% of the respondents were >59 years old (Fig. 1). Professionals were older than lay people (mean age, 39.0 vs. 36.6 years) and respondents from rural areas were older than those from metropolitan areas (mean age, 37.9 vs. 34.3 years).
Discussion
The importance of CPR training targeted at the families of cardiac patients has been stressed since the first CPR training programme [6]. The Scandinavian Resuscitation Council (SRC) has stated that the important target groups are people with known cardiac disease and their relatives, health care personnel and people aged 50 and over [8]. Despite this, there is a discrepancy between those trained in CPR and those most likely to witness a cardiac arrest [12], [13], [14], [15]. In terms of the
Acknowledgements
We wish to thank Jonny Lindqvist for his statistical analyses and Thomas Karlsson for statistical advice and scrutiny. We also thank the bank clerks, who helped us to test the questionnaire. Financial support: Heart and Lung Foundation, The Swedish Foundation for Healthcare Sciences and Allergy Research, Kamratförbundet Sahlgrensringen, 3M, Tika Läkemedel AB, Wilhelm and Martina Lundgren’s foundation for science.
References (44)
- et al.
Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation
Am. J. Emerg. Med.
(1985) - et al.
Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest
Ann. Emerg. Med.
(1995) - et al.
Single rescuer adult basic life support: an advisory statement from the Basic Life Support Working Group of the International Liaison Committee on Resuscitation
Resuscitation
(1997) - et al.
Survival after cardiac arrest outside hospital in Sweden
Resuscitation
(1998) - et al.
CPR training in the community
Ann. Emerg. Med.
(1985) - et al.
Are we training the right people yet? A survey of participants in public cardiopulmonary resuscitation classes
Resuscitation
(1998) - et al.
Layperson CPR — are we training the right people?
Ann. Emerg. Med.
(1984) - et al.
The location of the collapse and its effect on survival from cardiac arrest
Ann. Emerg. Med.
(1987) - et al.
Cardiopulmonary resuscitation training for family members of patients on cardiac rehabilitation programmes in Scotland
Resuscitation
(1999) - et al.
Resuscitation training for cardiac patients and their relatives — its effect on anxiety
Resuscitation
(1992)