FRIDAY, May 13, 2022 (American Heart Association News) — Black or Hispanic adults who experience a witnessed cardiac arrest outside the hospital are far less likely than their white peers to receive vital care from a bystander, new preliminary research shows. .

CPR was less likely for black and Hispanic adults in a less personal setting, such as on the street or in a public transportation hub, according to findings presented Friday at the Scientific Research Sessions on Quality of Care and Outcomes. of the American Heart Association in Reston, Virginia. Results were better at home or in public places where people might know the person, such as the workplace, although such CPR was still more likely for white people in the study.

“We hypothesized that in a public setting, bystander CPR rates would increase and the observed treatment difference at home would be smaller because more people are available to provide CPR,” said lead researcher Dr. R. Ángel García, a cardiology fellow at St. Luke’s Mid-America Heart Institute at the University of Missouri in Kansas City. “Unfortunately, it was the other way around. The disparity got bigger.”

Cardiac arrest occurs when a person’s heart suddenly stops pumping blood, which can be fatal if not treated immediately with CPR or a defibrillator to restore normal heart rhythm. About 370,000 cardiac arrests occur outside the hospital each year, most often in a person’s home, according to AHA statistics. People who receive CPR from family, friends, or strangers while waiting for emergency personnel to arrive are twice as likely to survive as those who don’t.

The researchers presented their initial findings at the American College of Cardiology Scientific Sessions in April. They analyzed 110,054 bystander-witnessed out-of-hospital cardiac arrest records between 2013 and 2019.

Initial findings showed that if their hearts stopped at home, black and Hispanic adults were 26% less likely to receive bystander CPR than whites. If cardiac arrest occurred in public, it was 41% less likely.

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In the latest analysis released Friday, bystander CPR response rates were compared in different public settings: the workplace, recreational facilities, on the street or highway, in transportation hubs or other public areas.

According to the new data, when black and Hispanic people suffered cardiac arrest in the workplace, they were 27% less likely to receive bystander CPR than their white co-workers. If they experienced cardiac arrest at a public transportation hub, they were 57% less likely. The results are considered preliminary until the full findings are published in a peer-reviewed journal.

Along with other factors, Garcia said the authors controlled for the age and gender of people who needed help because some people may be unnecessarily reluctant to give CPR to older people for fear of hurting them, or to women for fear of touching them inappropriately. inappropriate .

“The only thing left to describe why a person would not respond in a public setting is the person’s race,” he said. “Maybe there is an implicit bias. Or maybe they have a conscious bias against the person’s race. The reality is that we cannot explain which of those reasons would actually be present.”

Racism “is definitely one of the factors” keeping people from responding to black and Hispanic adults who need help, said Katie Dainty, chair of research at North York General Hospital and associate professor at the Institute for Policy, Management and Health Assessment at the University of Toronto in Canada.

“But that is a very difficult thing to measure,” he said. “What we need to do is address these concepts head-on — talk about them so we can proactively address them. And that is not easy. Bringing it out into the open like we are doing with this investigation is a step in the right direction.”

Dainty was not involved in the new research, but he did chair the writing committee for a recent AHA scientific statement on non-medical people who respond to CPR.

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According to the statement, only 35% to 45% of people worldwide who have out-of-hospital cardiac arrest receive bystander CPR. Previous research shows that people who live in predominantly black and Hispanic neighborhoods and people with low incomes are less likely to receive bystander CPR than people who live in predominantly white and higher-income neighborhoods.

“I was not surprised by these findings,” said Dainty, who also noted that they have always had trouble reaching low-income or racially diverse populations. “We haven’t really figured out how to tease out the problems that are unique to them.”

The findings suggest that it’s not just CPR skills that should be taught, he said.

“It’s about preparing people psychologically, including overcoming problems like racism, to respond to a human being in danger,” he said. “For a long time, the message has been that we just need to train more people. And that’s great, but what we really need to look at is why even trained people aren’t responding.”

People don’t need training to respond, experts say. All they need to do is press hard and fast in the center of the chest for 120 compressions per minute, at least 2 inches deep, according to AHA guidelines. 911 operators can also guide rescuers through CPR.

AHA vice president of science and innovation for emergency cardiovascular care, Dr. Comilla Sasson, was part of the team that conducted the new research.

News from the American Heart Association covers heart and brain health. Not all opinions expressed in this story reflect the official position of the American Heart Association. Copyright is owned by or owned by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email [email protected]

By Laura Williamson, American Heart Association News




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