PREPARATION, ATTITUDES AND BEHAVIOR IN NONHOSPITAL CARDIAC EMERGENCIES - EVALUATING A COMMUNITY READINESS TO ACT

OBJECTIVE: To determine how people in a moderately sized Ontario city believe they will react ii they witness someone collapsing. DESIGN: Te lephone survey. SETTING: The cities of Kitchener and Waterloo, pare of the Regional Municipality of Waterloo, Ontario, with a combined popul ation of 378,000. PARTICIPANTS: Households were randomly contacted and a questionnaire was administered, provided the respondent was over 44 years of age and agreed to be interviewed. Of 2479 households with el igible respondents, 811 (33%) completed the questionnaire. OUTCOMES: A ge, sex, educational level, cardiac risk factors and cardiopulmonary r esuscitation (CPR) training oi respondents were determined, as well as actions they would cake if cardiac arrest occurred in a family member at home or in stranger in the street, and associated emotions and bar riers to implementing actions. RESULTS: Among the first three actions that respondents who were not prompted with possible responses said th ey would take, 311 (72%) witnessing a collapse at home, compared with 166 (44%) witnessing a collapse on the street, would call 911, the pol ice or an ambulance. Other 'first three actions' in home collapse were checking for breathing (120 [28%]), checking for pulse (91 [21%]) and administering CPR (34 [8%]); these actions were less commonly selecte d in response to a strangers collapse and when respondents were not pr ompted. Respondents felt they would be more likely to perform CPR on a friend than on a stranger (OR 1.38, 95% CI 1.10 to 1.58). When asked how likely they would be to perform specific acts when witnessing a co llapse, 254 (69%) of respondents thought they would call their family doctor and 179 (48%) thought they were likely to begin chest compressi ons. Barriers to performing CPR centred around legalities and disease transmission. CONCLUSION: Older people do not know how to act effectiv ely in a cardiac emergency. Traditional CPR and public awareness progr ams have been ineffective in reaching this population; alternative mea ns are required to help the public respond more effectively to cardiac emergencies.