Determinants of physician reluctance to perform mouth-to-mouth resuscitation

• Published in: Journal of clinical epidemiology Vol. 53; no. 10; pp. 1054 - 1061
• Main Authors: Brenner, Barry E, Van, David C, Lazar, Eliot J, Camargo, Carlos A
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-2000; Elsevier
• Subjects: Acquired immunodeficiency disease; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Attitude of Health Personnel; Basic life support; Biological and medical sciences; Cardiac arrest; Cardiopulmonary Resuscitation; Chi-Square Distribution; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; HIV Infections - transmission; Human immunodeficiency virus; Humans; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Intensive care medicine; Logistic Models; Male; Medical sciences; Medical Staff, Hospital - psychology; Medicine; Refusal to Treat; Reproducibility of Results; Risk Factors; Sex Factors; Specialization; Statistics, Nonparametric; Surveys and Questionnaires; Basic life support; Human immunodeficiency virus; Cardiopulmonary resuscitation; Cardiac arrest; Acquired immunodeficiency disease; Human; Immunopathology; Cardiocirculatory arrest; Health staff; Determinant; Retroviridae; Physician; Cardiovascular disease; Respiratory intensive care; AIDS; Immune deficiency; Lentivirus; Epidemiology; Infection; Virus; Treatment; Viral disease; Professional practice
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/S0895-4356(00)00230-4

Objectives: Mouth-to-mouth resuscitation (MMR) is widely taught and promoted. The purpose of this study was to better characterize the observation that health professionals are reluctant to perform MMR and to identify determinants of this reluctance. Methods: 324 residents and faculty at a New York City teaching hospital were anonymously surveyed regarding their reluctance to perform MMR. One year later, medical staff were resurveyed. Results: Reluctance varied across scenarios: 70–80% of physicians were willing to perform MMR on a newborn or child, 40–50% for an unknown man, and 20–30% for a trauma victim or potentially gay man. Physicians reported very similar percentages for each scenario in the two surveys. Factors associated with MMR reluctance were female gender (OR = 2), resident physician (OR = 2), and higher perceived risk of contracting HIV from MMR (OR = 1.4 per unit on 5-point scale). In the year before the survey, 30% of all respondents witnessed an apneic patient who required MMR for whom ventilation was not provided for at least 2 minutes. Conclusions: Many physicians are reluctant to perform MMR. Marked delays in ventilation of apneic patients are occurring.