Bystander CPR - results and consequences from the Gottingen Pilot Project.

From 1985-1989 a community project on bystander CPR was carried out, including about 20.000 citizens; most of them were male, more than 60% younger than 30 years old. Evaluation of knowledge and skills among former participants in a realistic setting showed that six months after the course 66,7% performed according to AHA standards, after 12 and 24 months 23,5 % and 21,1%. Using a more practical method of interpreting the data with emergency medicine based criteria it could be found that after 6 months 90% of the test persons were able to improve the chances of survival in a real emergency, after 12 and 24 months each time 70%. The CPR data bank which has been established with the start of the project actually includes 1.825 cases. 70% of the patients on whom resuscitation has been attempted were male, mean age was 62 years. 60% of the emergencies occurred in the patients' home, 84% were witnessed, and 74% of cardiac origin. In 28% bystanders initiated resuscitation prior to the arrival of the EMS. Out of all 1.825 CPR attempts 35,8% were primarily successful, that means patients could be admitted to hospital with a spontaneous circulation. Following bystander CPR 42,4% of patients had VF in the first ECG compared with 29,1% in the non-bystander group. Corresponding to this out of the bystander group 43,6% of patients could be admitted to hospital with a spontaneous circulation, out of the non-bystander group only 32,7%. The positive effects of bystander CPR continued during the clinical course: 31,8% out of this group could be discharged without neurologic damage compared with 7,2% out of the non-bystander group. As far as long-term survival is concerned five years after discharge 53% of patients in whom bystanders had initiated resuscitation were alive and 31 % out of the non-bystander group. As an attempt to increase the rate of bystander initiated CPR and thus to bridge the interval without therapy a project on telephone CPR has started just recently.