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Vancouver Leads Canadian Cities in Bystander CPR

Bystanders, If your heart has stopped, you're unconscious, and you need CPR from a stranger, you're better off in Vancouver. That's because, in Toronto, fewer than one in three bystanders who see you struggling will try to help, according to a study by researchers at St. Michael's Hospital.

The response rate in Toronto was a dismal 30 per cent, similar to all major cities in Ontario, including Windsor, London and Ottawa. That compares to about 45 per cent in Vancouver and about 55 per cent in Seattle - roughly four or five in 10 people - stepping forward to assist. Toronto has "one of the lowest rates of bystanders helping others in the developed world," according to the study. People say they don't help because they don't know CPR and they're afraid of hurting a stranger.

"The answer to both is they're going to die if you do nothing," said Dr. Laurie Morrison, an emergency physician at St. Michael's Hospital who headed the research. "Doing anything is better than doing nothing." Elaine Parr learned that firsthand. She was at a Toronto Maple Leafs game at the Air Canada Centre in April 2007, when she saw a man one row in front and a couple of seats over slumped over, turning blue. It had been five years since Parr, who works in the financial industry, last took a CPR course. But that didn't stop her. "I heard someone say, 'Oh my God, he's sick.' I just hopped over the person that was next to me and pulled him back in his seat and I just started doing compressions on his chest," Parr recalled. "I didn't know what else to do other than I had to do something." She kept up the chest compressions until medical professionals who happened to be at the game stepped forward to assist.

A heart attack is characterized by chest pains, shortness of breath and sweatiness. The victim is conscious. Cardiac arrest is when the heart stops and the person has lost consciousness. That's when CPR is crucial because it ensures a continuous flow of blood to the brain. "You're keeping the heart and the brain alive until the EMS (emergency medical services) get there," Morrison said.

The focus of the population-based data study was to try to boost survival rates for heart attack outside the hospital by improving care provided by paramedics and firefighters. Morrison and her team tracked 11,000 incidents of cardiac arrest that occurred outside a hospital from 2004 to 2009. The good news is that in that time, the survival rate in the Toronto has tripled. The bad news is that the rate is still only 6 per cent, mostly because CPR has been unchanged for those years. When a good Samaritan attempts CPR, the chance of survival quadruples. When you call 911, the operator can give verbal instructions on how to administer CPR. "You can literally learn it over the phone if you just listen to the dispatcher and do exactly what they say."

The study also found that automated external defibrillators, which use electricity to shock the heart back into a normal rhythm, can also boost survival rates by 50 per cent. But they're used in only 1 per cent of cases in Toronto. These devices also have easy to understand voice commands.

In Ontario, the Good Samaritan Act protects individuals from being sued after trying to help others in an emergency medical situation. The man at the Maple Leafs game was later taken to hospital and survived. Today, Parr, 41, insists it was the others who saved his life. She's uncomfortable with the accolades that came her way. She's taken more CPR courses since then. "I just think it's critical now. I fully believe that all of us, even the kids, should have that knowledge. You never know when the situation is going to present itself and wouldn't you rather do something, rather than nothing?"


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