Canadians squeamish about CPR on strangers
DEPENDS ON VICTIM
Even doing away with the mouth-to-mouth “ick” factor of cardiopulmonary resuscitation isn’t enough to convince a significant proportion of Canadians to perform CPR on strangers, new research suggests.
New guidelines published in 2010 recommend that untrained bystanders who witness an adult collapse scrap “rescue breaths” and focus on deep and rapid chest compressions instead — because the evidence doesn’t support mouth-to-mouth making a difference.
However, a new survey suggests that while Canadians, and women in particular, are far more comfortable with hands-only CPR, our altruism depends on “victim characteristics.”
Only half are prepared to try to save the lives of strangers or “unkempt individuals.”
The study also exposes some deep and fundamental gaps in knowledge about CPR “that may contribute to bystander inaction at the scene of a cardiac arrest,” the authors report in the most recent issue of the Canadian Journal of Emergency Medicine.
Most of those surveyed couldn’t identify a cardiac arrest. Only 41 per cent knew it means the heart has stopped beating.
Twenty-one per cent confused it with a heart attack (where the heart hasn’t stopped).
Just 14 per cent were aware of the new, simpler CPR guidelines.
They were also overly optimistic about survival rates: half believed 50 per cent or more of individuals will survive a cardiac arrest outside hospital. The true rate is closer to eight per cent.
About 40,000 out-of-hospital cardiac arrests occur every year in Canada.
Early CPR and defibrillation can increase the chance of survival by 75 per cent, or greater.
However, bystander-CPR rates have rarely exceeded 30 per cent in Canada.
A major deterrent has been the lips-on-mouth component.
People fear contracting an infectious disease — even though the risk is remote.
“There’s always been a real concern, around the mouth-to-mouth piece, about safety and infections,” said Katie Dainty, the study’s senior author and a scientist at Li Ka Shing Knowledge Institute at Toronto’s St. Michael’s Hospital.
Led by graduate student Lindsay Cheskes and working with a survey company, the Toronto researchers polled 428 Canadian adults.
Among other things, people were asked how they would behave in different hypothetical scenarios.
Overall, when the victim was a family member or friend, there were no significant differences in willingness to perform cardio pulmonary resuscitation.
When the victim was a stranger, a greater proportion (55 per cent) was prepared to perform hands-only CPR versus mouth-to-mouth (39 per cent).
For “unkempt/homeless” victims, however, only 48 per cent were willing to provide compression-only resuscitation.
While that’s higher than the 28 per cent who said they would perform mouthto-mouth on the “unkempt/ homeless,” the finding speaks to a lingering discomfort issue, Dainty said.
“People do want to help — it’s not necessarily a question of not wanting to help. It’s just this idea of being that close to somebody,” said Dainty.
Some worried about “doing it right,” she said. But more so, it was about personal risk.
Part of the dilemma is CPR training.
It usually happens in “lovely clean rooms, using very clean, asexual mannequins,” far removed from messier, real-life conditions.
In followup interviews for a separate paper, “Some of the people we talked to just really couldn’t imagine even getting close enough to understand if the person had had a cardiac arrest,” Dainty said.
“I’m not sure that people actually understand that, if you don’t do something, the person will die.”
Signs of a cardiac arrest include sudden collapse, no pulse, no breathing or gasping, “agonal” breathing and loss of consciousness.
The new guidelines emphasize pushing hard and fast on the centre of the chest, between the nipples, at a rate of at least 100 compressions per minute.
People should not worry about breaking ribs, the guidelines also state.
IF YOU DON’T DO SOMETHING, THE PERSON WILL DIE.