Perspectives of emergency department attendees on outcomes of resuscitation efforts: origins and impact on cardiopulmonary resuscitation preference

Norkamari Shakira Bandolin; Weixiao Huang; Laurel Beckett; Garen Wintemute

doi:10.1136/emermed-2018-208084

Perspectives of emergency department attendees on outcomes of resuscitation efforts: origins and impact on cardiopulmonary resuscitation preference

Emerg Med J. 2020 Oct;37(10):611-616. doi: 10.1136/emermed-2018-208084. Epub 2020 Jul 13.

Authors

Norkamari Shakira Bandolin¹, Weixiao Huang², Laurel Beckett³, Garen Wintemute⁴

Affiliations

¹ Department of Emergency Medicine, University of California Davis, Sacramento, California, USA sbandolin@ucdavis.edu.
² Department of Statistics, University of California Davis, Sacramento, California, USA.
³ Department of Public Services, University of California Davis, Sacramento, California, USA.
⁴ Department of Emergency Medicine, University of California Davis, Sacramento, California, USA.

PMID: 32661063
DOI: 10.1136/emermed-2018-208084

Abstract

Background: Previous studies have shown that individuals overestimate the success of cardiopulmonary resuscitation (CPR) while underestimating its morbidity. Although perceptions of CPR success affect medical care in the emergency department (ED), no ED-based studies have been done.

Objective: To survey ED patients and their companions to assess their expectations, hypothesising that variation in information sources, prior exposure to CPR, and healthcare experience would influence predicted CPR success rates.

Methods: A survey was carried out of adults (age >18 years) in the ED waiting area of a tertiary care hospital between June and September 2016. An optimism scale was created to reflect expected likelihood of survival after CPR, or CPR success, under several sets of circumstances. Potential predictors of optimism for CPR outcome were examined using linear regression. Associations between optimism and CPR preference were evaluated using a Wilcoxon rank-sum test.

Results: There were 500 respondents and 53% had performed or witnessed CPR, and/or participated in a CPR course (64%). Television was the main source of information about CPR for >95% of respondents. At least half (51-64%) of respondents estimated the success rate of CPR as over 75% in all situations. Estimated CPR success rates were unrelated to age, sex, race, spiritual beliefs or personal healthcare experience. More than 90% of respondents wanted to receive CPR. Less than one-third of respondents had discussed CPR with a medical provider, but most wished to do so.

Conclusion: Consistent with prior studies, individuals overestimate the success rate of CPR. Healthcare experience does not appear to mitigate optimism about CPR, and individuals overwhelmingly want CPR for themselves. Though few had talked about CPR with a medical provider, most wanted to have informed decision-making conversations. Such discussions could help patients obtain a more realistic view of CPR outcomes.

Keywords: cardiac arrest; death/mortality; education; emergency department; resuscitation.

MeSH terms

Adult
California
Cardiopulmonary Resuscitation / methods*
Decision Making
Emergency Service, Hospital*
Female
Humans
Male
Patient Preference*
Prospective Studies
Surveys and Questionnaires
Tertiary Care Centers