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Study finds Baltimore bystanders less likely to perform CPR

Research found individuals experiencing out-of-hospital cardiac arrest in Baltimore were 45% less likely to receive bystander CPR compared to state and national averages

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Lt. Brandon Holland gives instruction to Jackson, and other Camp C.O.P.S. campers, learning CPR and first aid technique on Wednesday, at the Carroll County Farm Museum.

Brian Krista/staff photo

By Dillon Mullan
Baltimore Sun

BALTIMORE — A new study by local academics and emergency medical services found Baltimore City bystanders are less likely to provide CPR than those in Maryland and the rest of the country.

The study was a “rapid retrospective analysis of out-of-hospital cardiac arrest (OHCA) cases from Baltimore City between January 2020 and December 2022, using data from the Cardiac Arrest Registry to Enhance Survival.”


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The study was published in the Dove Medical Press and is credited as a collaboration between Johns Hopkins University, Baltimore City Community College, the University of Maryland, and the Baltimore City Fire Department. What it found was not encouraging, the study concludes.

“The findings of this preliminary analysis reveal that, as of 2022, individuals experiencing non-traumatic OHCA in Baltimore City were approximately 45% less likely to receive BCPR compared to both state and national averages,” the study’s authors wrote.

“This stark disparity persists despite the implementation of dispatch-assisted CPR protocols and targeted community education programs,” they wrote. “These results underscore the pressing need to explore and address the underlying barriers that contribute to the alarmingly low BCPR rates in Baltimore City.”

According to Hopkins, cardiac arrest is when the heart stops beating suddenly, and the lack of blood flow to the brain and other organs can cause a person to lose consciousness, become disabled or die if not treated immediately.

The study found 4,113 cases of out-of-hospital cardiac arrest from 2020 to 2022 in Baltimore City with a bystander CPR rate that decreased from 29.6% in 2020 to 27.4% in 2022.


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During the same period, the bystander CPR rate in Maryland ranged from 40.7% to 42.4% compared to around 40% nationally.

In 2022, nearly 71% of cases happened at homes or residences and victims had an average age of about 59. About 59% of cases were males and nearly 75% were African-Americans, according to the study.

The study found out of 1,282 cases of out-of-hospital cardiac arrest in Baltimore in 2022, a bystander performed CPR in 27.4% of them, compared to over 40% in Maryland and nationwide.

“Addressing these disparities may necessitate a health equity-focused investigation into public awareness, CPR training access, and sociocultural factors,” the study says.

There are nearly half a million cases of out-of-hospital cardiac arrest each year in the United States, according to the study, and less than 10% of victims survive to hospital discharge.

“Immediate intervention has been identified as a key determinant of both survival and favorable neurological outcomes,” the study says.

The study defines bystander CPR as any resuscitative effort provided by a layperson or non-medical professional prior to EMS arrival.

“These results underscore the pressing need to explore and address the underlying barriers that contribute to the alarmingly low [bystander CPR] rates in Baltimore City,” the study says. “Socioeconomic factors, including race/ethnicity, income inequality and education, have been linked to lower bystander CPR rates in underserved populations.”

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