Elsevier

Resuscitation

Volume 44, Issue 1, March 2000, Pages 27-36
Resuscitation

Attitudes of trained Swedish lay rescuers toward CPR performance in an emergency.: A survey of 1012 recently trained CPR rescuers

https://doi.org/10.1016/S0300-9572(99)00160-4Get rights and content

Abstract

There are currently 1.5 million trained cardiopulmonary resuscitation (CPR) rescuers in Sweden. Bystander CPR is performed on ≈30% of out-of-hospital cardiac arrests. The aim of this study was to analyse trained CPR rescuers’ attitudes and beliefs in terms of CPR performance in an emergency and differences with regard to gender, age, residential area and occupation. In a nation wide survey 1410, randomly selected, recently trained CPR rescuers were approached with a postal questionnaire, resulting in 1012 respondents. The mean age was 36.9 years and only 3% of the respondents were >59 years old. Only 1% had attended the course because of their own or a relative’s cardiac disease. Ninety-four per cent believed there was a minor to major risk of serious disease transmission while performing CPR. When predicting their willingness to perform CPR in six scenarios, 17% would not start CPR on a young drug addict, 7% would not perform CPR on an unkempt man, while 97% were sure about starting CPR on a relative and 91% on a known person. In four of six scenarios, respondents from rural areas were significantly more positive than respondents from metropolitan areas about starting CPR. In conclusion, readiness to perform CPR on a known person is high among trained CPR rescuers, while hesitation about performing CPR on a stranger is evident. Respondents from rural areas are more frequently positive about starting CPR than those from metropolitan areas.

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)

  • C Lester et al.

    Community life support training: does it attract the right people?

    Public Health

    (1997)
  • G.A Pane et al.

    Targeted recruitment of senior citizens and cardiac patients to a mass CPR training course

    Ann. Emerg. Med.

    (1989)
  • E Wilson et al.

    CPR skills retention of lay basic rescuers

    Ann. Emerg. Med.

    (1983)
  • J.P Ornato et al.

    Attitudes of BCLS instructors about mouth-to-mouth resuscitation during the AIDS epidemic

    Ann. Emerg. Med.

    (1990)
  • Å Axelsson et al.

    Bystander-initiated cardiopulmonary resuscitation out-of-hospital: a first description of the bystanders and their experiences

    Resuscitation

    (1996)
  • A.P McCormack et al.

    Disagreeable physical characteristics affecting bystander CPR

    Ann. Emerg. Med.

    (1989)
  • L Bossaert et al.

    Bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest: the cerebral resuscitation study group

    Resuscitation

    (1989)
  • R.O Cummins et al.

    Prehospital cardiopulmonary resuscitation: is it effective?

    J. Am. Med. Assoc.

    (1985)
  • J Herlitz et al.

    Effect of bystander initiated cardiopulmonary resuscitation on ventricular fibrillation and survival after witnessed cardiac arrest outside hospital

    Br. Heart J.

    (1994)
  • Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). J. Am. Med. Assoc....
  • Hjärt-lung räddning, Instruktörshandbok (CPR, Instructor’s manual). Scandinavian Resuscitation Council, Norway,...
  • Population and vital statistics by municipality and parish. Statistics Sweden, Population Statistics, Part 1, Örebro,...
  • Cited by (0)

    View full text