Study objective: To increase the rate of bystander CPR in a community
by use of a free, mailed, 10-minute videotape of CPR instruction. Desi
gn: Prospective, randomized intervention trial. One half of the househ
olds (8,659) received the free videotape (videotape group) and were co
nsidered the intervention group, and one half (8,659) served as the co
ntrol (no-videotape group). All households were followed from December
1991 to March 1993 to determine whether a cardiac arrest occurred and
who initiated CPR. A telephone interview obtained additional informat
ion about circumstances of the arrest and whether members of the house
hold viewed the videotape. Setting: City of Everett and South Snohomis
h County, Washington. A commercial mailing list was used to identify 1
7,318 households with a head of the household who was more than 50 yea
rs old. Participants: A case was defined as a cardiac arrest in which
CPR was initiated or continued by emergency medical services personnel
. Only cardiac arrests due to presumed underlying heart disease were i
ncluded. Arrests occurring after arrival of emergency medical services
personnel were not included. Interventions: The intervention was a fr
ee 10-minute videotape with CPR instructions mailed to the 8,659 inter
vention households. Paramedic run reports were reviewed and interviews
were conducted with cardiac arrest bystanders to determine who initia
ted CPR and whether they had received and viewed the videotape. Result
s: Sixty-five cardiac arrests occurred in the study households: 31 in
households that received the videotape and 34 in households that did n
ot review the videotape, The overall rate of bystander CPR was 47% in
the videotape group and 53% in the no-videotape group (P=NS). In nine
cardiac arrests, an individual was present who had watched the videota
pe; six of these nine cases (66%) had bystander CPR. Conclusion: Mass
mailings of CPR instructional videos are likely to be ineffective in i
ncreasing the rate of bystander CPR in a community.