Elsevier

Resuscitation

Volume 75, Issue 1, October 2007, Pages 82-87
Resuscitation

Clinical paper
Attitudes toward the performance of bystander cardiopulmonary resuscitation in Japan

https://doi.org/10.1016/j.resuscitation.2007.02.019Get rights and content

Summary

Background

Early initiation of bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival. The importance of bystander CPR is attracting more interest, and there has been an increase in attendance at CPR training courses in Japan. However, there have been few reports regarding Japanese attitudes toward the performance of bystander CPR. The present study was performed to identify current Japanese attitudes toward bystander CPR compared to our previous study performed in 1998.

Methods and results

Between February and March 2006, participants were asked about their willingness to perform CPR in five varying scenarios, i.e., performing CPR on a stranger, a trauma patient, a child, an elderly person, and a relative, and CPR techniques consisting of chest compression plus mouth-to-mouth ventilation (CC plus MMV) versus chest compression only (CC only). A total of 4223 individuals (male 50%) completed the questionnaire, including high school students, teachers, emergency medical technicians (EMTs), medical nurses, and medical students. About 70% of the subjects had experienced CPR training more than once. Only 10–30% of high school students, teachers, and health care providers reported willingness to perform CC plus MMV, especially on a stranger or trauma victim. In contrast, 70–100% of these subjects reported willingness to perform CC only, which was the same as in our previous study. The reasons for the unwillingness among laypeople to perform CC plus MMV were inadequate knowledge and/or doubt regarding whether they could perform the techniques effectively, while health care providers reported a fear contracting of a disease.

Conclusions

Most laypeople and health care providers are unlikely to perform CC plus MMV, especially on a stranger or trauma victim, but are more likely to perform CC only, as also found in our previous study in 1998. These findings suggest that MMV training should be de-emphasised and the awareness of CC alone should be emphasised because, for whatever reason, people do not want to perform MMV.

Introduction

Early initiation of bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival.1, 2 There is more awareness of the importance of bystander CPR and there has been an increase in attendance at CPR training courses in the USA, Europe, and Japan. In the 2005 guidelines, the American Heart Association recommended chest compression (CC) and mouth-to-mouth ventilation (MMV) as the best method of CPR.3 However, several studies have indicated that the need for mouth-to-mouth contact discourages not only laypeople, but also health care providers, from performing bystander CPR.4, 5, 6 Brenner et al. reported in 1997 that even physicians and future doctors are reluctant to perform MMV on arrest victims in the community.4 Our previous study performed in 1998 also showed that laypeople and health care providers have a disappointingly low willingness to perform CC plus MMV on strangers or trauma patients.7 However, recently there have been few reports about attitudes toward the performance of bystander CPR. Therefore, the present study was performed to identify Japanese attitudes toward the performance of bystander CPR compared with our previous study.

Section snippets

Demographics of respondents

The respondents were inhabitants of Ishikawa, Japan, a prefecture with a mixture of urban and rural environments and a resident population of over 1.1 million, which was the same as in our previous study.7 The respondents were high school students, high school teachers, emergency medical technicians (EMTs), nurses, and medical students. All respondents volunteered to take part and the survey was conducted by paper. The high school students, high school teachers were chosen randomly from 12 high

Respondents (Table 2)

A total of 4223 surveys were completed from 4400 surveys (96.0% completed). Of these, 2109 respondents (50%) were male. Among high school students, 38% were in the first year, 51% in the second year, and 11% in the last year of a 3-year programme.

About 70% of respondents had undertaken CPR training more than once. The number of previous CPR training courses among high school students was significantly lower than in our previous study. In contrast, the numbers of previous CPR training courses in

Discussion

Only 15–50% of laypeople and health care providers were likely to perform CC plus MMV, especially on a stranger and a trauma victim with blood on face, but 50–100% were likely to perform CC only, which was the same as the results of our previous study performed in 1998. The reasons for unwillingness among laypeople to perform CC plus MMV were their inadequate knowledge and/or doubt that they would be capable of performing CC plus MMV, while the main reason among health care providers was the

Conflict of interest

We have no financial and personal relationships with other people or organizations that could inappropriately influence our work.

References (16)

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    Early bystander CPR can significantly improve the survival rate from cardiac arrest (21,22). Lay persons with previous training are more willing than those without training to perform bystander CPR and have more positive attitudes toward CPR (23−25). It has been proven that primary school students can perform CPR effectively, and starting CPR training early may strengthen interest and motivation (26).

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A Spanish translated version of the summary of this article appears as Appendix in the final online version at 10.1016/j.resuscitation.2007.02.019.

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