Public Perception and Willingness Towards Bystander Cardiopulmonary Resuscitation (CPR) Training and Performance in Pakistan

  • Uzair Ali Khan The Downtown School , Seattle
  • Ayaan Ali Khan International Community School, Kirkland,USA
  • Zoya Ali Khan Lahore Grammar School International school Lahore
  • Rashk e Hinna Pak Emirates Military Hospital Rawalpindi
  • Muhammad Bilal Khattak Pak Emirates Military Hospital (PEMH) ,Rawalpindi
  • Rao Saad Ali Khan Pak Emirates Military Hospital (PEMH) ,Rawalpindi
Keywords: Cardiopulmonary Resuscitation (CPR), Pakistan, Survey, Questionnaire

Abstract


Background/Aim: Bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrest increases both survival rates and neurological recovery, but in Pakistan, an alarmingly low 2.3 % of these individuals receive bystander CPR. This study was designed to identify the reasons that affect the perception and willingness of the public toward bystander CPR training and performance in Lahore, Pakistan.

Methods: A CPR master trainer from the USA visited various organisations from 1 December 2022 to 31 January 2023, to conduct training sessions. Before and after the training, a questionnaire was distributed among respondents to fill in. The subjects were asked to answer questions about their perception and willingness to perform bystander CPR.

Results: Out of 401 participants, 240 completed the survey, with a response rate of 59.85 %. The majority of them were males [146 (60.8 %)], 215 (89.6 %) were below the age of 40, 107 (44.6 %) were graduated, 182 (75.8 %) never participated in any CPR training, mainly due to their ignorance towards the importance of bystander CPR (52.8 %) and 152 (63.3 %) were eager to participate in the CPR training course. Furthermore, the leading problem in providing bystander CPR was lack of technique or fear of possible harm that can be proved fatal (48.8 %), followed by concerns related to involvement in any legal procedure (10.0 %).

Conclusions: Bystander CPR is still uncommon in Pakistan. Participants were reluctant to perform bystander CPR because of various concerns and fears. Lack of proper skill and causing additional harm were the main reasons associated with this. Hence, while improving CPR training and public education, these findings must be considered.

References

Majid A, Jamali M, Ashrafi MM, Ul Haq Z, Irfan R, Rehan A, et al. Knowledge and attitude towards cardiopulmonary resuscitation among doctors of a Tertiary Care Hospital in Karachi. Cureus 2019;11(3):e4182. doi: 10.7759/cureus.4182.

Berdowski J, Berg RA, Tijssen JGP, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation 2010;81:1479-87.

Chen M, Wang Y, Li X, Hou L, Wang Y, Liu J, et al. Public knowledge and attitudes towards bystander cardiopulmonary resuscitation in China. Biomed Res Int 2017;2017:3250485. doi: 10.1155/2017/3250485.

Hasselqvist-Ax I, Riva G, Herlitz J, Rosenqvist M, Hollenberg J, Nordberg P, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med 2015;372:2307-15.

Huang EPC, Chiang WC, Hsieh MJ, Wang HC, Yang CW, Lu TC, et al. Public knowledge, attitudes, and willingness regarding bystander cardiopulmonary resuscitation: a nationwide survey in Taiwan. J Formos Med Assoc 2019;118(2):572-81.

Khan UR, Khudadad U, Baig N, Ahmed F, Raheem A, Hisam B, et al. Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan. BMC Emergency Med 2022 Jun 3;22(1):93. doi: 10.1186/s12873-022-00652-2.

Dwood SB, Al-Mosawi HS, Khudhair AS, Al-Mussawi AA. Evaluation of effectiveness of planned teaching programmers regarding basic life support (BLS) among nursing staff in Basra General Hospital. Int J of Nursing 2014;1(2):155-66.

Rajeswaran L, Cox M, Moeng S, Tsima BM. Assessment of nurses' cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana. Afr J Prim Health Care Fam Med 2018;10(1):1-6.

Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, et al. European resuscitation council guidelines for resuscitation 2010 section 1. Executive summary. Resuscitation 2010;81(10):1219-76.

Kuramoto N, Morimoto T, Kubota Y, Maeda Y, Seki S, Takada K, et al. Public perception of and willingness to perform bystander CPR in Japan. Resuscitation 2008;79(3):475-81.

Roshana S, Batajoo K, Piryani R, Sharma M. Basic life support: knowledge and attitude of medical/paramedical professionals. World J Emerg Med 2012;3:141-5.

Zaheer H, Haque Z. Awareness about BLS (CPR) among medical students: status and requirements. J Pak Med Assoc 2009;59:57-9.

Zamir Q, Nadeem A, Rizvi AH. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan. J Pak Med Assoc 2012;62:1361-4.

Siddiqui A, Ahmed N, Ahmed A, Aslam A. A profound insight of cardiopulmonary resuscitation (CPR) in Pakistan. NJHS 2017;2(4):142-3.

Ko JS, Kim SR, Cho, BJ. The effect of cardiopulmonary resuscitation (CPR) education on the CPR knowledge, attitudes, self-efficacy, and confidence in performing CPR among elementary school students in Korea. Healthcare (Basel) 2023 Jul 17;11(14):2047. doi: 10.3390/healthcare11142047.

Malmström B, Nohlert E, Ewald U, Widarsson M. Simulation-based team training improved the self-assessed ability of physicians, nurses and midwives to perform neonatal resuscitation. Acta Paediatr 2017;106:1273-9.

Oteir AO, Kanaan SF, Alwidyan MT, Almhdawi KA, Williams B. Validity and reliability of a cardiopulmonary resuscitation attitudes questionnaire among allied health profession students. Open Access Emer Med 2021;13:83-90.

Cheskes L, Morrison LL, Beaton D, Parsons J, Dainty, KN. Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)- a nation-wide public survey. CJEM 2016;18(4):253-63.

Daud A, Nawi AM, Aizuddin, AN, Yahya MF. Factors and barriers on cardiopulmonary resuscitation and automated external defibrillator willingness to use among the community: A 2016-2021 systematic review and data synthesis. Glob Heart 2023 Aug 25;18(1):46. doi: 10.5334/gh.1255.

Johnston TC, Clark MJ, Dingle GA, FitzGerald G. Factors influencing Queenslanders' willingness to perform bystander cardiopulmonary resuscitation. Resuscitation 2003;56(1):67-75.

Mao J, Chen F, Xing D, Zhou H, Jia L, Zhang Y. Knowledge, training and willingness to perform bystander cardiopulmonary resuscitation among university students in Chongqing, China: a cross sectional study. BMJ Open 2021;11:1-9.

Dobbie F, MacKintosh AM, Clegg G, Stirzaker R, Bauld L. Attitudes towards bystander cardiopulmonary resuscitation: results from a cross-sectional general population survey. PLoS ONE 2018;13(3):e0193391. doi: 10.1371/journal.pone.0193391.

Iqbal A, Nisar I, Arshad I, Butt UI, Umar M, Ayyaz M, et al. Cardiopulmonary resuscitation: knowledge and attitude of doctors from Lahore. Ann Med Surg (Lond) 2021;69(1):102600. doi: 10.1016/j.amsu.2021.102600.

Ahmed F, Khan UR, Soomar SM, Raheem A, Naeem R, Naveed A, et al. Acceptability of telephone-cardiopulmonary resuscitation (T-CPR) practice in a resource-limited country- a cross-sectional study. BMC Emerg Med 2022 Aug 2;22(1):139. doi: 10.1186/s12873-022-00690-w..

Sondergaard KB, Wissenberg M, Gerds TA. Bystander cardiopulmonary resuscitation and long-term outcomes in out-of-hospital cardiac arrest according to location of arrest. Eur. Heart J 2019;40:309-18.

Park YM, Shin SD, Lee YJ, Song KJ, Ro YS, Ahn KO. Cardiopulmonary resuscitation by trained responders versus lay persons and outcomes of out-of-hospital cardiac arrest: a community observational study. Resuscitation 2017;118:55-62.

Ishtiaq O, Iqbal M, Zubair M, Qayyum R, Adil M. Outcome of cardiopulmonary resuscitation - predictors of survival. J Coll Physicians Surg Pak 2008;18(1):3-7.

Published
2023/12/21
Section
Original article