CPR training across a community did not improve cardiac arrest survival
Barely one in ten people survives an out-of-hospital cardiac arrest. Community CPR training seemed like an obvious fix. A large randomized trial delivers a sobering result.
Researchers randomly assigned 60 counties in North Carolina to either receive an intensive training programme for bystanders, 911 dispatchers, and first responders, or to continue with standard practice. The trial, presented at the American Heart Association and published in the New England Journal of Medicine, followed more than 22,000 people who suffered cardiac arrest outside hospital. The result: survival with a good neurological outcome did not improve.
Training improved CPR delivery, but not survival
In the trial’s fourth year, the proportion of patients who received CPR from a bystander increased, suggesting that this part of the training had an effect. But that improvement in delivery did not translate into more survivors during this study period. Participants had a median age of 64; 37% were women, 33% were Black, and 29% lived in rural areas.
Denmark as a reference point
The lead author compared results with Denmark, where 80% of the population is trained in CPR. There, 75% of cardiac arrest patients receive rapid assistance, and survival stands at 16% compared to 10% in the US. In North Carolina, only about 5% of the population received training. The researcher stressed that achieving the kind of population-level impact seen in Denmark takes decades, not two or three years. The team plans to follow participants for at least another year.
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