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Poster Presentations / Res

ystander CPR. However, the multiple logistic regression analysisnalysed for bystander-witnessed OHCAs with bystander CPR dis-losed that neither the type nor the origin of bystander CPR was anndependent factor for the 1-month favourable outcome and thatarly emergency call and short response time were independentactors related to the outcomes.

Conclusions: Early activation of EMS and rapid EMS responseather than type and origin of bystander CPR are significant factorselated to favourable outcome of bystander-witnessed OHCAs.

ttp://dx.doi.org/10.1016/j.resuscitation.2012.08.102

P044

hy do bystanders initiate CPR in Norway?

enche Torunn Mathiesen 1,∗, Sindre Høiland 2, Conrad Arnfinnjørshol 1, Eldar Søreide 1

Stavanger University Hospital, Stavanger, NorwayUniversity of Stavanger, Stavanger, Norway

Introduction: Bystanders are responsible for initiating thewo first links in the “Chain of survival”; alarming the dispatchenter and performing cardiopulmonary resuscitation (CPR). Inter-ationally, there are huge differences in bystander’s willingness toerform CPR.1 One of the reasons for not performing CPR has beenear of legal proceedings.2 Bystander CPR rate is over 70% in ouregion.3 The aim of this study was to reveal bystanders expectationso the Emergency Medical Services (EMS), fear of reactions fromegal proceedings and expected responses from family and friendso the act of initiating CPR to patients who suffered out-of-hospitalardiac arrest (OHCA) in our region.

Methods: Six bystanders, who called the EMS and/or initiatedPR to OHCA patients surviving to the hospital, took part in a quali-ative study. In-depth interviews with open-ended and continuousuestions, suited to obtain here-and-now understanding of con-extual and social aspects behind the motivation to initiate CPRere used.4 The interview focused on: values, knowledge, nor-ative obligation, confidence, and surroundings. For example, the

ystanders were asked about their expectations from the EMS andxpected responses from family and friends, and whether they hadxperienced any adverse reactions.

Results: All bystanders expected an immediate response fromhe EMS and acknowledgement from their family and friends forcting in a life-threatening emergency. None of the bystandersentioned any fear of legal proceedings.Conclusion: Predictability of a rapid and professional response

rom the EMS and acknowledgement from family and friends seemo be the main prerequisites for bystanders to call EMS and tonitiate CPR in Norway. There was an absence of fear from legalroceedings after CPR. These findings may help explain the overalligh bystander CPR rate in our region3 but are most likely not thenly reasons for the high bystander CPR rate.

eferences

. Sasson C, et al. Predictors of survival from out-of-hospital cardiac arrest: a sys-tematic review and meta-analysis. Circ Cardiovasc Qual Outcomes;3:63–81.

. Savastano S, Vanni V. Cardiopulmonary resuscitation in real life: the most frequentfears of lay rescuers. Resuscitation 2011;82:568–71.

. Lindner TW, et al., Good outcome in every fourth resuscitation attempt is achiev-

able – an Utstein template report from the Stavanger region. Resuscitation.

. Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills, CA: Sage; 1985. p. 416 s.

ttp://dx.doi.org/10.1016/j.resuscitation.2012.08.103

tion 83 (2012) e24–e123 e41

CPR QualityAP045

What bystanders of out-of-hospital cardiac arrest really do:Quality of chest compressions and implications for outcome

Jan Breckwoldt 1,∗, Sebastian Schlösser 1, Hans-Richard Arntz 2

1 Charité – University Medicine Berlin, Benjamin Franklin Medical Cen-tre, Department of Anaesthesiology, Berlin, Germany2 Charité – University Medicine Berlin, Department of Cardiology,Berlin, Germany

Background: Outcome from out-of-hospital cardiac arrest(OOHCA) is strongly related to bystander CPR, especially to thequality of chest compressions (CCs). However, very limited data isavailable on the definite quality of bystander CCs. This study aimedto gather data of CC quality performed by bystanders and to relatethem to patients’ outcome.

Methods: Over a 12-month period we analysed all witnessedOOHCAs treated by two physician-staffed emergency medicalservice (EMS) vehicles in a metropolitan area. To approximatebystander CC quality we conducted semi-structured interviewswith bystanders in respect to their actions and connected themto observations by the first EMS personnel arriving on scene.Favourable neurologic outcome was rated as overall performancecategories (OPC) grade 1 or 2 obtained after 3 months.

Results: Out of 201 eligible missions 200 were completelyassessed by EMS personnel. 25 cases (12.5%) were rated as ‘effectiveCC’, 44 (22%) as ‘ineffective CC’, in 35 cases (17.5%) the patient wasfound in recovery position, and 96 (48%) no actions were observed.143 bystanders could be interviewed. CCs were plausibly reportedby bystanders in 58 cases (40.6% of interviews): from these cases20 were rated as ‘effective CC’ by EMS personnel, 27 cases as ‘inef-fective CC’, and 11 cases ‘no CCs observed’.

Favourable neurologic outcome (OPC 1 or 2) after 3 months inpatients with ‘effective CC’ was 36.0% (9 of 25) compared to 5.2% (5of 96) in patients with ‘no CC’ (p = 0.01).

Conclusion: In witnessed OOHCA in a German metropolitanarea self reported bystander CC rate was 40.6%, and observedbystander CC rate was 34.5%. However, observed effectivebystander CCs were only found in 12.5%. Good neurologic survivalafter 3 months was 7-fold higher in the ‘effective CC’ group as com-pared to the group without bystander CC.

http://dx.doi.org/10.1016/j.resuscitation.2012.08.104

AP046

Chest compression alone CPR is associated with better long-term survival compared to standard CPR

Florence Dumas 1,∗, Thomas D. Rea 2, Carol Fahrenbruch 2, Mar-tin Rosenqvist 3, Jonas Faxen 4, Leif Svensson 3, Mickey Eisenberg 2,Katarina Bohm 5

1 Inserm U970-Paris Descartes University, Paris, France2 EMS, Division of Public Health Seattle and King County, Seattle, WA,USA3 Section of Cardiology, Karolinska Institutet, Stockholm, Sweden4 Department of Internal Medicine, Nyköping Hospita, Nykoping,Sweden5 Karolinska Institutet, Department of Clinical Science and Education,Södersjukhuse, Stockholm, Sweden

Objective: Little is known about the long-term survival effectsof type-specific bystander CPR in the community. We hypothe-sized that dispatcher instruction consisting of chest compression