Do blacks get bystander cardiopulmonary resuscitation as often as whites?

doi:10.1016/S0196-0644(94)70246-2

Annals of Emergency Medicine

Volume 24, Issue 6, December 1994, Pages 1147-1150

https://doi.org/10.1016/S0196-0644(94)70246-2 Get rights and content

Study objective: To determine whether there is an associationbetween the race of a victim of out-of-hospital cardiac arrest and the provision of bystander-initiated CPR.

Design: Record review of 1,068 consecutive cases of nontraumatic out-of-hospital cardiac arrest.

Setting: Memphis, Tennessee, a city of more than 600,000 withroughly equal numbers of white and black residents.

Participants: Every adult who was seen by municipal emergencymedical services personnel for nontraumatic cardiac arrest between March 1, 1989, and June 5, 1992.

Intervention: None.

Results: Although black and white cardiac arrest victims weresimilar in many respects, black victims received bystander CPR substantially less frequently than whites (9.8% versus 21.4%; odds ratio, 0.46; 95% confidence interval, 0.34 to 0.61). This difference was slightly more pronounced when the victim collapsed in a public place. In addition to race of the victim, location of the arrest outside the home and having the arrest witnessed were independent determinants of whether a victim was given bystander CPR. Multiple logistic regression analysis showed that the effect of race was independent of the other variables studied.

Conclusion: Black victims of out-of-hospital cardiac arrestreceive bystander CPR less frequently than white victims. Targeted training programs may be needed to improve the rates of bystander CPR among certain groups.

Section snippets

INTRODUCTION

Out-of-hospital cardiac arrest is the most prominent medical emergency in the United States, accounting for more than 250,000 deaths every year.¹ Timely provision of bystander CPR is associated with successful resuscitation and long-term survival.¹ In Memphis, Tennessee, a city with roughly equal numbers of black and white residents (58.6% are black and 41.1% are white), the rate of provision of bystander CPR is substantially less than that reported in other cities of similar size .2, 3

MATERIALS AND METHODS

All adults who had an out-of-hospital cardiac arrest in Memphis of presumed cardiac etiology between March 1, 1989, and June 5, 1992, were identified in conjunction with a prospective trial of first-responder defibrillation.³ The Memphis Fire Department (MFD) emergency medical services (EMS) system is the sole provider of advanced life support (ALS) to persons within the city limits. Cases of cardiac arrest due to trauma, drug overdose, and other noncardiac etiologies were excluded, as were

RESULTS

One thousand sixty-eight cases of out-of-hospital cardiac arrest were identified during the study period. Six hundred three victims (56%) were black, and 465 (44%) were white. The mean age of black victims (61.9±11.3 years) was lower than that for white victims (67.4±8.9 years), and the black group contained more females (43.4% versus 29.5%, χ² P<.05). The proportion of black victims who received bystander CPR was substantially less than that of white victims (9.8% versus 21.4%; odds ratio,

DISCUSSION

Large cities with substantial black populations appear to have very low survival rates from out-of-hospital cardiac arrest despite rapid EMS response times.⁴ In this study, we found that black victims of out-of-hospital cardiac arrest in Memphis were significantly less likely to get bystander CPR than were white victims. Recent studies in Chicago and Seattle found that black victims of out-of-hospital cardiac arrest were less likely to receive bystander CPR than white victims, although the

CONCLUSION

Black victims of out-of-hospital cardiac arrest received bystander CPR much less frequently than white victims. Other variables known to influence the provision of bystander CPR, such as whether the arrest was witnessed and location of collapse, did not account for the difference between the two groups. Further research is needed to determine the reasons that certain groups are less likely to receive bystander CPR. This should lead to the design of specific interventions designed to increase

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Impact of first-responder defibrillation in an urban emergency medical services system
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There are more references available in the full text version of this article.

Cited by (0)

^**: This study was supported by grant HS-06094-02 from the Agency for Health Care Policy and Research, Rockville, Maryland.

^***: Presented in part at the AnnualMeeting of the Society for Academic Emergency Medicine, San Francisco, California, May 1993.

^***: Reprint no. 47/1/60384

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Do blacks get bystander cardiopulmonary resuscitation as often as whites?**,***,***

Section snippets

INTRODUCTION

MATERIALS AND METHODS

RESULTS

DISCUSSION

CONCLUSION

Ann Emerg Med

Ann Emerg Med

Improving survival from sudden cardiac arrest: The "chain of survival" concept

Circulation

Impact of first-responder defibrillation in an urban emergency medical services system

JAMA

Do blacks get bystander cardiopulmonary resuscitation as often as whites?,*,***