Vadeboncoeur Tyler, Bobrow Bentley J, Clark Lani, Kern Karl B, Sanders Arthur B, Berg Robert A, Ewy Gordon A
Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA.
Resuscitation. 2007 Oct;75(1):68-75. doi: 10.1016/j.resuscitation.2007.02.015. Epub 2007 Apr 30.
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.
To determine true incidence and location of layperson CPR in the State of Arizona.
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.
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.
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.
旁观者心肺复苏术（CPR）可显著降低院外心脏骤停的死亡率。因此，非专业人员心肺复苏是院外心脏骤停患者生存链中的一个重要组成部分。全州范围内非专业人员心肺复苏的发病率及发生地点尚不清楚。
确定亚利桑那州非专业人员心肺复苏的实际发病率及发生地点。
亚利桑那州心脏拯救登记与教育（SHARE）项目审查了由30个负责约67%亚利桑那州人口的市政消防部门自愿提交的急救医疗首诊报告。除了标准的乌斯坦风格数据外，还记录了有关旁观者心肺复苏实施情况、旁观者职业及医疗培训情况以及心脏骤停发生地点的信息。
全州报告的推测为心脏病因的院外成人心脏骤停总数为1097例。心脏骤停发生在私人住宅的占67%，长期护理机构或医疗机构的占18%，公共场所的占15%。在所有心脏骤停病例中，37%实施了旁观者心肺复苏，住宅内心脏骤停病例中24%实施了旁观者心肺复苏，长期护理机构或医疗机构内心脏骤停病例中76%实施了旁观者心肺复苏，公共场所心脏骤停病例中52%实施了旁观者心肺复苏。旁观者心肺复苏使生存几率比达到2.2[95%可信区间1.2 - 4.1]。排除在有正式心肺复苏培训且将其作为工作职责一部分的旁观者在场情况下发生的心脏骤停病例，在857例病例中有218例（25%）实施了非专业人员心肺复苏。
全州范围内非专业人员心肺复苏的发病率极低。这种低水平的旁观者心肺复苏可能导致心脏骤停总体生存率较低。公共卫生官员应重新评估当前的心肺复苏公众教育模式。
