CPR Training Should Focus on High-Risk Neighborhoods: Experts

Focusing CPR education in certain neighborhoods could save more lives, according to a new American Heart Association scientific statement.

Survival rates for out-of-hospital cardiac arrests vary widely in the United States, ranging from 0.2 percent in Detroit to 16 percent in Seattle, according to the statement. This is due in part to whether bystanders are willing to do cardiopulmonary resuscitation, or CPR. One life is saved for every 30 bystanders who do CPR.

Bystanders provide CPR only 40 percent of the time, however, and CPR rates vary widely by location.

Communities should identify neighborhoods with high rates of out-of-hospital cardiac arrests and low rates of bystander CPR and then focus CPR education efforts in those high-risk neighborhoods, according to the statement, which appears Feb. 25 in the journal Circulation.

This can be done using geographic information systems that map the latitude and longitude of each cardiac arrest.

"We have always had a one-size-fits-all approach, blanketing a whole area with CPR training, and we assume that will get to everyone," statement lead author Dr. Comilla Sasson, an assistant professor in the emergency medicine department at the University of Colorado Anschutz Medical Campus, said in an American Heart Association news release. "We are now saying that we need to shift our thinking to target CPR training to the areas where it is most needed."

There are many reasons bystanders don't perform CPR. Some people are unaware of Good Samaritan laws that protect them and worry that they will be sued if they do CPR wrong and cause harm. Others may be reluctant to attempt CPR due to concerns about immigration status issues, Sasson said.

Research shows that neighborhoods that are predominately black or Hispanic have higher rates of cardiac arrest but lower rates of CPR compared to predominately white neighborhoods. Bystander CPR rates also are lower in poorer neighborhoods, regardless of race.

The statement also said there should be a standardized dispatcher-assisted program for 911 operators to provide CPR instructions to bystanders trying to help a cardiac arrest victim.

Sasson noted that the 9.5 percent cardiac arrest survival rate in the United States has been about the same for three decades. New strategies to promote CPR are needed to increase the survival rate, she said.

More information

The American Academy of Family Physicians has more about CPR.