Clinical paperAttitudes toward the performance of bystander cardiopulmonary resuscitation in Japan☆
Introduction
Early initiation of bystander cardiopulmonary resuscitation (CPR) improves the chances of successful resuscitation and survival.1, 2 There is more awareness of the importance of bystander CPR and there has been an increase in attendance at CPR training courses in the USA, Europe, and Japan. In the 2005 guidelines, the American Heart Association recommended chest compression (CC) and mouth-to-mouth ventilation (MMV) as the best method of CPR.3 However, several studies have indicated that the need for mouth-to-mouth contact discourages not only laypeople, but also health care providers, from performing bystander CPR.4, 5, 6 Brenner et al. reported in 1997 that even physicians and future doctors are reluctant to perform MMV on arrest victims in the community.4 Our previous study performed in 1998 also showed that laypeople and health care providers have a disappointingly low willingness to perform CC plus MMV on strangers or trauma patients.7 However, recently there have been few reports about attitudes toward the performance of bystander CPR. Therefore, the present study was performed to identify Japanese attitudes toward the performance of bystander CPR compared with our previous study.
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Demographics of respondents
The respondents were inhabitants of Ishikawa, Japan, a prefecture with a mixture of urban and rural environments and a resident population of over 1.1 million, which was the same as in our previous study.7 The respondents were high school students, high school teachers, emergency medical technicians (EMTs), nurses, and medical students. All respondents volunteered to take part and the survey was conducted by paper. The high school students, high school teachers were chosen randomly from 12 high
Respondents (Table 2)
A total of 4223 surveys were completed from 4400 surveys (96.0% completed). Of these, 2109 respondents (50%) were male. Among high school students, 38% were in the first year, 51% in the second year, and 11% in the last year of a 3-year programme.
About 70% of respondents had undertaken CPR training more than once. The number of previous CPR training courses among high school students was significantly lower than in our previous study. In contrast, the numbers of previous CPR training courses in
Discussion
Only 15–50% of laypeople and health care providers were likely to perform CC plus MMV, especially on a stranger and a trauma victim with blood on face, but 50–100% were likely to perform CC only, which was the same as the results of our previous study performed in 1998. The reasons for unwillingness among laypeople to perform CC plus MMV were their inadequate knowledge and/or doubt that they would be capable of performing CC plus MMV, while the main reason among health care providers was the
Conflict of interest
We have no financial and personal relationships with other people or organizations that could inappropriately influence our work.
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A Spanish translated version of the summary of this article appears as Appendix in the final online version at 10.1016/j.resuscitation.2007.02.019.