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Knowledge and barriers of out of hospital cardiac arrest bystander intervention and public access automated external defibrillator use in the Northeast of England: a cross-sectional survey study

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Abstract

Intervention by members of the public during an out of hospital cardiac arrest (OHAC) including resuscitation attempts and accessible automated external defibrillator (AED) has been shown to improve survival. This study aimed to investigate the OHCA and AED knowledge and confidence, and barriers to intervention, of the public of North East England, UK. This study used a face-to-face cross-sectional survey on a public high street in Newcastle, UK. Participants were asked unprompted to explain what they would do when faced with an OHCA collapse. Chi-Square analysis was used to test the association of the independent variables sex and first aid trained on the participants’ responses. Of the 421 participants recruited to our study, 82.9% (n = 349) reported that they would know what to do during an OHCA collapse. The most frequent OHCA action mentioned was call 999 (64.1%, n = 270/421) and 58.2% (n = 245/421) of participants reported that they would commence CPR. However, only 14.3% (n = 60/421) of participants spontaneously mentioned that they would locate an AED, while only 4.5% (n = 19/421) recounted that they would apply the AED. Just over half of participants (50.8%, n = 214/421) were first aid trained, with statistically more females (57.3%, n = 126/220) than males (43.9%,  n = 87/198) being first aiders (p = 0.01 χ2 = 7.41). Most participants (80.3%, n = 338/421) knew what an AED was, and 34.7% (n = 326/421) reported that they knew how to use one, however, only 11.9% (n = 50/421) mentioned that they would actually shock a patient. Being first aid trained increased the likelihood of freely recounting actions for OHCA and AED intervention. The most common barrier to helping during an OHCA was lack of knowledge (29.9%, n = 126/421). Although most participants reported they would know what to do during an OHCA and had knowledge of an AED, low numbers of participants spontaneously mentioned specific OHCA and AED actions. Improving public knowledge would help improve the public’s confidence of intervening during an OHCA and may improve OHCA survival.

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Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

OHCA:

Out of hospital cardiac arrest

AED:

Automated external defibrillator

CARES:

Cardiac arrest registry to enhance survival

PAD:

Public access automated external defibrillator

OR:

Odds ratio

CI:

Confidence interval

NRCPR:

National Registry of Cardiopulmonary Resuscitation

CPR:

Cardiopulmonary resuscitation

CA:

Cardiac arrest

BLS:

Basic life support

DH:

The department of health

CARU:

Cardiac arrest response unit

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Acknowledgements

The authors would like to thank all participants who took part in this study. Thank you to the North East Ambulance Service (NEAS) for their support. The authors would like to thank Liam Townend, Aoife Norton and Ciara Norton for their help during this project.

Funding

This project was funded by Cardioproof CIC.

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Authors and Affiliations

  1. School of Medicine, Faculty of Health Sciences and Wellbeing, Sciences Complex, University of Sunderland, City Campus, Chester Road, Sunderland, SR1 3SD, UK

    Rosie Dew, Michael Norton & Scott Wilkes

  2. Department of Community Cardiology, Grindon Lane Primary Care Centre, South Tyneside and Sunderland NHS Foundation Trust, Grindon Lane, Sunderland, SR3 4DE, UK

    Michael Norton

  3. North East Ambulance Service, Bernicia House, Goldcrest Way, Newburn Riverside, Newcastle Upon Tyne, NE15 8NY, UK

    Michael Norton, Paul Aitken-Fell, Phil Blance, Steven Miles & Sean Potts

  4. Great North Air Ambulance Service, Progress House, Urlay Nook Road, Eaglescliffe, Stockton-On-Tees, TS16 0QB, UK

    Steven Miles

  5. 49 Marine Avenue Medical Group (Northumbria Primary Care), Whitley Bay, North Tyneside, NE26 1AN, UK

    Scott Wilkes

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Contributions

MN, RD and SW designed the study. RD, MN, PA-F, PB, SM and SP collected the study data. RD analysed the data and wrote the first draft of the paper with MN. All authors reviewed and edited the paper.

Corresponding author

Correspondence to Rosie Dew.

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The authors state they have no conflicts of interest.

Ethics approval and consent to participate

Ethical approval was granted by the University of Sunderland Research Ethics Committee. Identifiable personal data were not collected from participants. Participation was voluntary and agreeing to answer the survey was considered as consent to participate in the study.

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Dew, R., Norton, M., Aitken-Fell, P. et al. Knowledge and barriers of out of hospital cardiac arrest bystander intervention and public access automated external defibrillator use in the Northeast of England: a cross-sectional survey study. Intern Emerg Med (2024). https://doi.org/10.1007/s11739-024-03549-z

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