CPR training, knowledge needed
Study looks at how race, other factors affect likeliness of getting help
CHICAGO — People who collapse from cardiac arrest in poor black neighborhoods are half as likely to get CPR from family members at home or bystanders on the street as those in better-off white neighborhoods, according to a study that found the reasons go beyond race.
The findings suggest a big need for more knowledge and training, the researchers said.
The study looked at data on more than 14,000 people in 29 U.S. cities. It's one of the largest to show how race, income and other neighborhood characteristics combine to affect someone's willingness to offer heart-reviving help.
More than 300,000 people suffer a cardiac arrest in their homes or other non-hospital settings every year, and most don't survive. A cardiac arrest is when the heart stops, and it's often caused by a heart attack, but not always. Quick, hard chest compressions can help people survive.
For their study, researchers looked at the makeup of neighborhoods and also the race of the victims. They found that blacks and Hispanics were 30 percent less likely to be aided than white people. The odds were the worst if the heart victim was black in a low-income black neighborhood.
The researchers also found that regardless of a neighborhood's racial makeup, CPR was less likely to be offered in poor areas. That shows that socio-economic status makes more difference than the neighborhood's racial makeup, said lead author Dr. Comilla Sasson, of the University of Colorado in Denver.
While few people in poor black neighborhoods got CPR, those who did faced double the odds of surviving. Overall, only 8 percent of patients survived until at least hospital discharge, but 12 percent of those who got bystander CPR did versus just 6 percent of those who did not.
About 80 percent of the cardiac arrest victims in the study had collapsed in their own homes. That suggests lack of knowledge about how to do CPR. But also, people tend to panic and freeze when they encounter someone in cardiac arrest, and they need to know that cardiopulmonary resuscitation is easier than many realize, Sasson said.
She said the study results should prompt public outcry — especially since most people who suffer cardiac arrest in non-hospital settings won't survive and those statistics haven't changed in 30 years.
"We can't accept that anymore," she said. "It shouldn't matter where I drop to have someone help me," Sasson said.
The study appears in Thursday's New England Journal of Medicine.
The researchers analyzed data from 2005-2009 from a cardiac arrest registry coordinated by the federal Centers for Disease Control and Prevention and Emory University. They also examined U.S. Census data in cities where study patients were stricken — including Atlanta; Boston; Columbus, Ohio; Denver; Houston; Nashville; and San Francisco. Whether similar results would be found in small cities or rural areas isn't known.
Much of the research was done before experts changed CPR advice in a move many think may encourage bystanders to offer help. American Heart Association guidelines issued in 2008 emphasize quick, hard chest compressions rather than mouth-to-mouth resuscitation — removing some of the discomfort factor.
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