Neighborhood, Race, and CPR

An New England Journal of Medicine article looks at the probability of a bystander performing CPR based on neighborhood characteristics including income and race:

Among 14,225 patients with cardiac arrest, bystander-initiated CPR was provided to 4068 (28.6%). As compared with patients who had a cardiac arrest in high-income white neighborhoods, those in low-income black neighborhoods were less likely to receive bystander-initiated CPR (odds ratio, 0.49; 95% confidence interval [CI], 0.41 to 0.58). The same was true of patients with cardiac arrest in neighborhoods characterized as low-income white (odds ratio, 0.65; 95% CI, 0.51 to 0.82), low-income integrated (odds ratio, 0.62; 95% CI, 0.56 to 0.70), and high-income black (odds ratio, 0.77; 95% CI, 0.68 to 0.86). The odds ratio for bystander-initiated CPR in high-income integrated neighborhoods (1.03; 95% CI, 0.64 to 1.65) was similar to that for high-income white neighborhoods.

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  1. Joe says:

    I’ve been trained in CPR. I remember thinking about how terrifying it’d be to have to administer it, despite “good samaritan” laws. I felt like I’d be more vulnerable to an ugly lawsuit if I screwed up, especially since popular belief of CPR is that it will resuscitate people. While in reality, it’s more of a way to give medics/emts more time to get to the scene.

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    • Rob says:

      Even without screwing up, I think that you’re putting yourself in the path of a lawsuit. Given the ease and low risk of filing a lawsuit in the US, I cannot imagine that I would ever perform CPR on anyone who I didn’t know. I would think twice (and I mean really really have to consider it) before performing CPR, first aid, or emergency AED on anyone outside of my own family.

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      • Chalres L. says:

        I don’t want to be sued, but personally I’m not a fan of watching people die. I am CPR trained and if I thought someone needed help, I would administer without hesitation. The lawsuits can wait until after the EMTs have arrived.

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      • Enter your name... says:

        Rob, the point behind good samaritan laws is that anyone who files such a suit gets laughed out of court, frequently with all the defendant’s costs paid. Such lawsuits are rare these days. I can’t remember ever hearing of a lawsuit against a bystander who performed CPR on an unconscious person.

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      • Rob says:

        Having never actually found myself in a situation where CPR, first aid, or AED was called for this has to be relegated to the status of thought experiment but that thought has been in my mind every time I’ve so much as looked at a pamphlet from the Red Cross and it was the first thing I asked about at the end of AED training. The answer I got there wasn’t very reassuring; in a nutshell, “that could happen but doing something is better than doing nothing”

        I don’t have much faith in good Samaritan laws. Those laws differ from state to state and some of them only protect professionals. Even in a state where I am protected, there is little to nothing for an ambulance chaser to lose by filing a lawsuit and forcing me to hire my own lawyer or cough up a few thousand to avoid the hassle.

        Probably, I’m just being cranky. I’d like to think that I wouldn’t have it in me to walk away from someone who needed help but the thought is there. I blame the legal profession.

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  2. John says:

    Anyone can be sued for anything, but that doesn’t mean the plaintiff will win.

    Almost every state has Good Samaritan laws that protect them from liability. The only case I’ve found where a person was sued somewhat successfully was Van Horn V. Torti in California, and that case revolved around the “rescue” from a burning vehicle, not actual medical care. As soon as the Supreme Court stated that the rescuer could be liable, the State of California fell all over itself to pass a new law reversing the decision and exempting rescuers in the future.

    Learn CPR and do it if given the opportunity. You might save a life.

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    • Fred says:

      “Anyone can be sued for anything, but that doesn’t mean the plaintiff will win.”

      While I agree with you, one should also remember that you would still need to pay for a lawyer to defend you. “Court appointed” doesn’s apply to civil suits right?

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      • Travis says:

        It doesn’t, but most states have cost shifting provisions in the case of frivolous law suits. While it does create a burden, no doubt, sticking it out just for a short while can be worth it for the defendant.

        Additionally, if you get a frivolous civil suit when court appointed attorney isn’t an option, you can potentially get an attorney to defend you on a contingency fee (contingent that they get to keep all attorney fees awarded when it’s thrown out).

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  3. mannyv says:

    I think what this is saying is that bystanders in poor neighborhoods don’t know CPR.

    So…do we offer CPR classes in poor neighborhoods?

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  4. Eric M. Jones. says:

    In Massachusetts we just passed an assisted suicide law. I’m going to get the suicide kit and keep in my first aid kit just in case.

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  5. Bob says:

    In my unscientific opinion, the low-income ones could be explained by saying that low-income people don’t have the time to go take CPR training. The results for high-income blacks is puzzling though.

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  6. mannyv says:

    CPR requires that you kiss a stranger. Where and under what circumstances would you kiss a stranger?

    Also, the numbers are meaningless if you don’t know who’s delivering CPR. It could be that low and high income blacks don’t know CPR as well, while white high-income people do. Both integrated and white high-income neighborhoods have high-income whites, thus have higher rates of CPR.

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    • Enter your name... says:

      Actually, the current recommendation is that you ignore rescue breathing for the first five minutes or so, and focus on rapid (100+/minute) chest compressions. For most of us, the professionals will have arrived before you need to “kiss” anyone.

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  7. CPR Courses says:

    CPR courses provide the basic knowledge of how to help in critical situation and how to provide the patient firstly need for saving their life so CPR is necessary traning for everyone

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