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Cardiopulmonary resuscitation
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===Chance of receiving CPR=== Various studies show that in out-of-home cardiac arrest, bystanders in the US attempt CPR in between 14%<ref name=swor>{{cite journal | vauthors = Swor RA, Jackson RE, Cynar M, Sadler E, Basse E, Boji B, Rivera-Rivera EJ, Maher A, Grubb W, Jacobson R | title = Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest | journal = Annals of Emergency Medicine | volume = 25 | issue = 6 | pages = 780β784 | date = June 1995 | pmid = 7755200 | doi = 10.1016/S0196-0644(95)70207-5 }}</ref> and 45%<ref name=wik>{{cite journal | vauthors = Wik L, Steen PA, Bircher NG | title = Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest | journal = Resuscitation | volume = 28 | issue = 3 | pages = 195β203 | date = December 1994 | pmid = 7740189 | doi = 10.1016/0300-9572(94)90064-7 }}</ref> of the time, with a median of 32%.<ref name=physorg>{{cite web | title = Members of the public lack skills, confidence necessary to save lives with CPR, research shows | url = http://medicalxpress.com/news/2011-11-members-lack-skills-confidence-cpr.html | date = November 12, 2011 | access-date = November 12, 2011 | url-status = live | archive-url = https://web.archive.org/web/20120112233945/http://medicalxpress.com/news/2011-11-members-lack-skills-confidence-cpr.html | archive-date = January 12, 2012 }}</ref> Globally, rates of bystander CPR are reported to be as low as 1% and as high as 44%.<ref>Comilla Sasson et al. on behalf of the American Heart Association Council on Quality of Care and Outcomes Research et al. ''Circulation'' 2013; 127: 1342β1350, {{cite journal | vauthors = Sasson C, Meischke H, Abella BS, Berg RA, Bobrow BJ, Chan PS, Root ED, Heisler M, Levy JH, Link M, Masoudi F, Ong M, Sayre MR, Rumsfeld JS, Rea TD | title = Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for healthcare providers, policymakers, public health departments, and community leaders | journal = Circulation | volume = 127 | issue = 12 | pages = 1342β1350 | date = March 2013 | pmid = 23439512 | doi = 10.1161/CIR.0b013e318288b4dd | url = http://circ.ahajournals.org/content/127/12/1342.full.pdf+html | access-date = 2015-01-03 | url-status = live | s2cid = 3448678 | doi-access = free | archive-url = https://web.archive.org/web/20150223231619/http://circ.ahajournals.org/content/127/12/1342.full.pdf+html | archive-date = 2015-02-23 }}</ref> However, the effectiveness of this CPR is variable, and the studies suggest only around half of bystander CPR is performed correctly.<ref>{{cite journal | vauthors = Van Hoeyweghen RJ, Bossaert LL, Mullie A, Calle P, Martens P, Buylaert WA, Delooz H | title = Quality and efficiency of bystander CPR. Belgian Cerebral Resuscitation Study Group | journal = Resuscitation | volume = 26 | issue = 1 | pages = 47β52 | date = August 1993 | pmid = 8210731 | doi = 10.1016/0300-9572(93)90162-J }}</ref><ref>{{cite journal | vauthors = Gallagher EJ, Lombardi G, Gennis P | title = Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest | journal = JAMA | volume = 274 | issue = 24 | pages = 1922β1925 | date = December 1995 | pmid = 8568985 | doi = 10.1001/jama.274.24.1922 }}</ref> One study found that members of the public having received CPR training in the past lack the skills and confidence needed to save lives. The report's authors suggested that better training is needed to improve the willingness to respond to cardiac arrest.<ref name=physorg /> Factors that influence bystander CPR in out-of-hospital cardiac arrest include: * Affordable training * Target CPR training to family members of potential cardiac arrest * CPR classes should be simplified and shortened * Offer reassurance and education about CPR * Provide clearer information about legal implications for specific regions * Focus on reducing the stigma and fears around providing bystander CPR<ref>{{Cite journal| vauthors = Carragher R, Johnson J, Harder M |date=2017|title=Factors that influence bystander CPR: A narrative review|journal=International Journal of Current Research|volume=9 | issue = 6 |pages=52100β52103|hdl=10613/5277}}</ref> There is a relation between age and the chance of CPR being commenced. Younger people are far more likely to have CPR attempted on them before the arrival of emergency medical services.<ref name=swor/><ref>{{cite journal | vauthors = Jackson RE, Swor RA | title = Who gets bystander cardiopulmonary resuscitation in a witnessed arrest? | journal = Academic Emergency Medicine | volume = 4 | issue = 6 | pages = 540β544 | date = June 1997 | pmid = 9189184 | doi = 10.1111/j.1553-2712.1997.tb03574.x }}</ref> Bystanders more commonly administer CPR when in public than when at the person's home, although healthcare professionals are responsible for more than half of out-of-hospital resuscitation attempts.<ref name=wik/> People with no connection to the person are more likely to perform CPR than family members.<ref name=bossaert>{{cite journal | vauthors = Bossaert L, Van Hoeyweghen R | title = Bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. The Cerebral Resuscitation Study Group | journal = Resuscitation | volume = 17 | issue = Suppl S55β69 | pages = S55β69; discussion S199β206 | year = 1989 | pmid = 2551021 | doi = 10.1016/0300-9572(89)90091-9 }}</ref> There is also a clear relation between the cause of arrest and the likelihood of a bystander initiating CPR. Laypersons are most likely to give CPR to younger people in cardiac arrest in a public place when it has a medical cause; those in arrest from trauma, [[exsanguination]] or intoxication are less likely to receive CPR.<ref name=bossaert/> It is believed that there is a higher chance that CPR will be performed if the bystander is told to perform only the chest compression element of the resuscitation.<ref name=EMS37-6/><ref>{{cite book|title=First Aid and Extended Care | edition = 5th | vauthors = Tilton B |chapter=CPR|publisher=Morris Book Publishing, LLC. & Falcon Guides|editor=Buck Tilton|page=[https://archive.org/details/backcountryfirst00tilt/page/20 20]|year=2007|isbn=978-0-7627-4357-5|chapter-url-access=registration|chapter-url=https://archive.org/details/backcountryfirst00tilt|url=https://archive.org/details/backcountryfirst00tilt/page/20}}</ref> The first formal study into gender bias in receiving CPR from the public versus professionals was conducted by the [[American Heart Association]] and the [[National Institutes of Health]] (NIH), and examined nearly 20,000 cases across the U.S. The study found that women are six percent less likely than men to receive bystander CPR when in [[cardiac arrest]] in a public place, citing the disparity as "likely due to the fear of being falsely accused of [[sexual assault]]."<ref>{{Cite web|url=https://www.upi.com/Health_News/2018/11/05/Bystanders-less-likely-to-give-CPR-to-women/3721541447788/|title=Bystanders less likely to give CPR to women|website=UPI|language=en|access-date=2019-06-05}}</ref><ref>{{Cite news|url=https://www.theguardian.com/world/2017/nov/12/cpr-gender-women-men-bystanders-study|title=Fear of touching women's chests may be barrier to giving CPR, researchers say|agency=Associated Press|date=2017-11-12|work=The Guardian|access-date=2019-06-05|language=en-GB|issn=0261-3077}}</ref>
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