Abstract 98: The Assessment and Value of Bystander Cardio Pulmonary Resuscitation (by-CPR)

Background: 3 million people in Sweden are educated in CPR and the value of this has been questioned if this leads to increased By-CPR and survival. Aim: To describe different aspects and effect on survival after OHCA depending if bystander CPR (By-CPR) was performed or not, and if the bystander was Lay or Medical educated. Also to explore the effects from CPR training on times to CPR, alarm and on outcome, when a medical educated bystander perform CPR versus when a Lay person act. Methods: Patients in the Swedish Cardiac Arrest Registry receiving bystander CPR 1990-2011 were included and divided into: No-ByCPR , and By-CPR . By-CPR was further divided in Lay-ByCPR and Med-ByCPR when CPR was performed by professionals in terms of medical educated bystanders. Crew witnessed cases were excluded. Results: In all 61 704 patients are included in the registry, and among them 30 188 bystander witnessed cases (49 %) were included in this survey. By-CPR have over the years continuously increased from 40% to 68% and 30 days survival increased from 3.8% 1990 to 10.7% 2011. Survival was 4.0% in No-ByCPR, 10.6% in By-CPR, 9.4% in Lay-ByCPR and 13.7% in Med-ByCPR. Various aspects on delay to treatment were independently associated with survival to one month: Collapse-call for EMS (OR 0.70;95% CI 0.64-0.77); collapse-start of CPR (OR 0.72;95% CI 0.68-0.76); call for arrival of EMS (OR 0.41;95% CI 0.36-0.46). (Adjusted for age, gender, place and etiology) Lay-ByCPR was significant better than No-ByCPR (OR 2.49) in all patients. Med-ByCPR had even better outcome compared to No-ByCPR (OR 2.84). When comparing Med-ByCPR vs. Lay-ByCPR bystanders, there were non- significant differences, OR 1.18 (CI:0.98-1.41). Conclusion: Increased By-CPR correlate to increased survival and can more than double survival rate compared to No-ByCPR. Collapse to call, start of CPR, call-arrival EMS were independently associated with survival to one month. Lay-ByCPR were better than no ByCPR and as good as Med-ByCPR.