03/21/2022
Great Read for Lay Rescuer CPR/AED
For the first time, experts have provided a concise review of the latest data on the experience of lay people who have performed CPR, assessing their perspectives on training, their motivation to take action, and the psychological impact of witnessing and responding to an out-of-hospital cardiac arrest (OHCA). The findings are covered in an AHA scientific statement titled, “ Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest,” that was published today in the organization’s flagship journal, Circulation.
There is significant evidence about the effectiveness of bystander CPR, as well as research that evaluates the type and amount of training that is most effective. However, only a minority of studies have been conducted to try to understand the reasons why people do or do not respond in an OHCA and that describe their experiences in the situation.
Over 70% of OHCA incidents among adults happen in homes. Therefore, students who take CPR training need to understand that the person they perform CPR on is likely to be a loved one.
Statement Addresses Support for Lay Responders after CPR
The crucial need to provide support for lay responders after performing CPR, regardless of the outcome, is an important part of the new statement. Studies document varying physical and emotional responses from people who have assisted during a cardiac arrest, highlighting the fact that the psychological impact is not insignificant.
Responders have noted experiencing exhaustion, guilt, flashbacks, sleep disturbances, self-doubt, anger, sadness, and fear. A positive outcome to performing CPR mitigated some of the emotional responses, but psychological responses were wide-ranging and individualized. In situations with a failed resuscitation attempt, PTSD symptom scores were twice as high for responders as those for nonwitnesses.
Practical Application of the Statement to Consider for CPR Training
As the statement notes, possessing the knowledge and skills to perform CPR and use an AED is only one part of a lay responder’s preparedness. But it’s also just as important that lay responders are emotionally prepared to take action.
The statement’s authors suggest different ways to contextualize CPR training, which will further improve the readiness and experience of future responders. Among the suggestions to consider including in CPR training are:
Dispel the common myths about bystander CPR, which are barriers to taking action. The statement covers the myths.
Clearly explain how the benefit of a potential rescue outweighs the risk of harm for an unresponsive patient
Address the positive and negative psychological effects of responding to a cardiac arrest and discussions of the resources available to lay responders after the event
Help students envision the use of CPR and encourage them to develop a plan that may empower them to act. This is important because most cardiac arrests happen at home.
Offer debriefing as a support tool to students who witness and respond to cardiac arrest events. Debriefing has been shown to provide coping skills, to increase confidence for potential future CPR attempts, and to promote a positive perception of the responder’s own performance.
Lay responders are heroes regardless of the cardiac arrest outcome. They deserve our best efforts to make their future education, debriefing, and peer support more responder-centered.
