Code Blue: Disparities in Bystander CPR

White individuals are more likely to experience bystander CPR intervention during a cardiac event at home or in public than Black or Hispanic individuals, who are 26% and 37% less likely to receive CPR, respectively.

Trends in bystander CPR for persons with out-of-hospital cardiac arrest

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Those who get training in how to deliver CPR are prepared to intervene if they witness a cardiac arrest. Unfortunately, however, only 32% of people experiencing a cardiac event in public or at home receive CPR from a bystander. Among those who experience cardiac arrests, Black individuals are reported to have lower survival rates compared to White individuals. Differences in bystander intervention may contribute to this disparity. However, any racial differences in CPR performed outside hospitals have yet to be determined.

Researcher R. Angel Garcia and colleagues used data from the Cardiac Arrest Registry to Enhance Survival (CARES) to determine trends in bystander CPR performed in the home or public from 2013 to 2019 in the United States. Trained EMS responders record data about out-of-hospital events for the registry, with hospital personnel collecting survival outcome statistics. From the registry, the researchers identified 110,054 cardiac arrests witnessed by bystanders. They determined whether the event occurred in the home or in public, and classified the overall neighborhood racial/ethnic makeup and the general income of the residents.

Overall, 32.2% of witnessed cardiac arrests occurred in Black or Hispanic individuals. White individuals were consistently found to be more likely to experience bystander intervention, with Black and Hispanic individuals being 26% and 37% less likely to receive CPR in the home and/or public settings, respectively.

Various factors may explain this disparity, including the cost of CPR training and language differences between the patient and CPR administer. The researchers note several areas for improvement, including offering low or no-cost CPR training in Black and Hispanic communities and engaging community leaders to reduce any existing mistrust of the police and medical systems so that trained providers can arrive early to the scene.

Databyte via R. Angel Garcia, John A. Spertus, Saket Girotra, et al. Racial and Ethnic Differences in Bystander CPR for Witnessed Cardiac Arrest. The New England Journal of Medicine, 2022.