Abstract 314: The Impact of City-Level Public Health Interventions on Increased Bystander Cardiopulmonary Resuscitation

Abstract only Introduction: Bystander cardiopulmonary resuscitation (B-CPR) may increase a victim’s chance of survival from sudden cardiac arrest (SCA), but B-CPR rates are low in many communities. Few studies have examined the association of city-wide public health interventions on B-CPR. Objective...

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Published in:	Circulation (New York, N.Y.) Vol. 140; no. Suppl_2
Main Authors:	Blewer, Audrey L, Ho, Andrew F, Binte Ahamad, Nur Shahidah, White, Alexander E, Pek, Pin Pin, Ng, Yih Yng, Mao, Desmond Ren Hao, Tiah, Ling, Chia, Michael Yih-Chong, Leong, Benjamin Sieu-Hon, Cheah, Si Oon, Tham, Lai Peng, Kua, Phek Hui Jade, Arulanandam, Shalini, Ostbye, Truls, Bosworth, Hayden B, Ong, Marcus E
Format:	Journal Article
Language:	English
Published:	19-11-2019
Online Access:	Get full text
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Summary:	Abstract only Introduction: Bystander cardiopulmonary resuscitation (B-CPR) may increase a victim’s chance of survival from sudden cardiac arrest (SCA), but B-CPR rates are low in many communities. Few studies have examined the association of city-wide public health interventions on B-CPR. Objectives: We sought to assess whether there is variation in B-CPR by intervention and location of arrest. We hypothesized that implementation of dispatch-assisted CPR (DA-CPR), CPR/AED training, and a first responder mobile application (myResponder) would increase B-CPR by two-fold. Methods: We conducted a retrospective study of adult, non-traumatic SCAs from the Singapore registry (4/2010-12/2016). Interventions included DA-CPR (7/2012 - present), CPR/AED training (04/2014 - present), and myResponder (4/2015 - present). Using logistic regression, we modeled the likelihood of receiving B-CPR by increased number of interventions over time. We examined these effects together, in the home, and public accounting for patient-level confounding. Results: From 2010-2016, the Singapore registry contained 12,546 SCA events. Excluding pediatric, EMS witnessed, and healthcare facility arrests, 7,476 were analyzed. Of these, mean age was 66±15 and 68% were male. B-CPR was administered in 45% of the events and varied by location (home: 43% v public: 52%). With implementation of DA-CPR, likelihood of B-CPR increased (OR: 3.5 (2.9-4.2) p<0.01) compared to no intervention; with implementation of CPR/AED training, likelihood of B-CPR increased compared to no intervention (OR: 5.8 (4.8-7.0), p<0.01). Lastly, implementation of myResponder resulted in a 7.09 increased likelihood of B-CPR compared to no intervention (OR: 7.1 (5.9-8.4), p<0.01). Variation was seen when examining likelihood of B-CPR by all interventions compared to no intervention, in the home (OR: 8.7 (7.0-10.7)) and the public (OR: 4.0 (2.9-5.6)). Survival increased, corresponding to the increase in B-CPR. Conclusion: City-level public health interventions increased the likelihood of layperson B-CPR, while variation was seen in the home and public. Understanding the impact of public health interventions may shed light on strategies to increase B-CPR and inform targeted initiatives to improve survival from SCA.
ISSN:	0009-7322 1524-4539
DOI:	10.1161/circ.140.suppl_2.314