The Save Hearts in Arizona Registry and Education (SHARE) program: who is performing CPR and where are they doing it?

BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) decreases mortality from out-of-hospital cardiac arrest significantly. Accordingly, layperson CPR is an integral component in the chain of survival for out-of-hospital cardiac arrest victims. The near statewide incidence and location of layperson CPR is unknown.

OBJECTIVE: To determine true incidence and location of layperson CPR in the State of Arizona.

METHODS: The Save Hearts in Arizona Registry and Education (SHARE) program reviewed EMS first care reports submitted voluntarily by 30 municipal fire departments responsible for approximately 67% of Arizona's population. In addition to standard Utstein style data, information regarding the performance of bystander CPR, the vocation and medical training of the bystander and the location of the arrest were documented.

RESULTS: The total number of out-of-hospital adult arrests of presumed cardiac etiology reported statewide was 1097. Cardiac arrests occurred in private residences in 67%, extended care or medical facilities in 18%, and public locations in 15%. Bystander CPR was performed in 37% of all arrests, 24% of residential arrests, 76% of extended care or medical facility arrests, and 52% of public arrests. Bystander CPR provided an odds ratio of 2.2 for survival [95% CI 1.2-4.1]. Excluding cardiac arrests which occurred in the presence of bystanders with formal CPR training as part of their job description, layperson CPR was performed in 218 of 857 (25%) of cases.

CONCLUSIONS: The near statewide incidence of layperson CPR is extremely low. This low rate of bystander CPR is likely to contribute to the low overall survival rates from cardiac arrest. Public health officials should re-evaluate current models of public education on CPR.