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Monday, December 26, 2011

The Quantitative Effect of Bystander CPR

An article published by Circulation and written by Yonemoto et al. has quantified the effect of Bystander CPR. It's conclusive.

See www.slicc.org/Yonemoto_A18041_Circulation.pdf

The investigators examined all cases in the All-Japan Utstein Registry of sudden cardiac arrests occurring in 2006 through 2009, where the arrests were witnessed by a lay-person 18 years old or older. Nearly 20,000 cases were available. The definition of 'survival' used was 'discharged with CPC-1 or CPC-2 neurological status'. (i.e., totally neurologically intact, or able to perform the activities of daily living without assistance.)

The graph in the abstract was cropped in transmission. The full graph is at www.slicc.org/Circ_CPRAEDvsCPR_Japan.jpg

The short form is that - based upon a 20,000 victim cohort - it is really clear that CPR + AED use results in a lot more CPC-1 and CPC-2 survivals than CPR alone.

for those who were defibrillated in the [left column] number of minutes;
the percentage of those who survived (CPC 1,2) with Bystander CPR and AED use are in the second column;
the percentage of those who survived (CPC 1,2) with AED use only are in the third column;
the percentage of those who didn't survive but didn't die (CPC 3,4,5) are in the fourth column.
Min C,A A DNS

01 22% 32% 46%

02 24% 29% 44%

03 27% 28% 41%

04 29% 26% 45%

05 30% 24% 45%

06 31% 21% 48%

07 32% 20% 48%

08 29% 19% 48%

09 28% 18% 46%

10 26% 15% 49%

11 23% 14% 63%

...

...well, you get the picture. You can see the trend. If you have Bystander CPR plus AED use, you have extra time to bring the victim back. If you have only AED use, the victims either make it or not a shorter time from the time of the arrest.

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