AHA Calls for Targeted CPR Education in High-Risk Neighborhoods

In a new scientific statement published in Circulation, the American Heart Association says this could boost the number of bystanders willing to intervene.

Bidding to increase the nation’s survival rates with out-of-hospital cardiac arrest, the American Heart Association has published a new scientific statement in its journal Circulation calling for targeted CPR education in high-risk neighborhoods.

Bystanders perform CPR only 40 percent of the time, and participation rates vary widely, as do out-of-hospital cardiac arrest survival rates, according to AHA, which cited the 0.2 percent survival rate in Detroit and the 16 percent survival rate in Seattle. The national rate of 9.5 percent has been static for three decades.

The statement calls for communities to determine which of their neighborhoods have a high incidence of out-of-hospital cardiac arrests and low rates of bystander CPR by using geographic information systems to map the location of each cardiac arrest. It says they should then focus public education efforts in the high-risk neighborhoods.

"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," Dr. Comilla Sasson, M.D., MS, the statement’s lead author and assistant professor in the Department of Emergency Medicine at the University of Colorado Anschutz Medical Campus in Denver, said in a Feb. 25 AHA 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. You have to have that kind of data to understand there are going to be specific areas that need to be targeted to increase awareness of cardiac arrest symptoms and how to do bystander CPR."

She said charting the addresses of everyone who receives CPR training also can be helpful: "Are we hitting the same people who have always been trained and not really impacting these higher-risk neighborhoods?"

The statement also recommends a standardized, dispatcher-assisted telephone program for 911 operators to provide CPR instructions to willing bystanders. Co-authors of the statement are Hendrika Meischke, Ph.D.; Benjamin S. Abella, M.D., MPH; Frederick Masoudi, M.D., MPH; Michael R. Sayre, M.D.; Robert A. Berg, M.D.; Bentley J. Bobrow, M.D.; Marcus Ong, M.D.; Elisabeth Dowling Root, Ph.D.; Paul S. Chan, M.D., M.Sc.; Michele Heisler, M.D., MPH; Jerrold H. Levy, M.D.; Mark Link, M.D.; John S. Rumsfeld, M.D., Ph.D.; and Thomas D. Rea, M.D., MPH.

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