CPR Readiness Among Emergency Department Patients: Training, Knowledge Gaps, Legal Awareness, and Willingness to Act

Bystander cardiopulmonary resuscitation (CPR) improves survival after sudden cardiac arrest, yet readiness among emergency department (ED) patients is uncertain. We measured CPR training, knowledge, and concerns and hypothesized that training, prior CPR performance, and bystander-law familiarity would be associated with greater confidence and comfort.

We administered an anonymous cross-sectional survey to a convenience sample of adult ED patients at two academic hospitals. Of 887 respondents, 35 incomplete surveys were excluded (final sample size 852). Outcomes were high confidence performing CPR and comfort helping a stranger in public. Knowledge items included questions regarding adult compression rate, criteria to start CPR, as well as basic bystander CPR laws. We used chi-square tests and multivariable logistic regression adjusting for demographics; results are reported as adjusted odds ratio (aOR) with 95% confidence intervals (CI).

Among 852 participants, 64.7% reported prior CPR training and 15.6% had performed CPR. Correct compression rate and start criteria were selected by 34.6% and 32.0%, respectively. High confidence was reported by 44.5% and 71.6% were comfortable helping in public. Most participants (88.0%) would attend training if offered. Only 23.7% were familiar with state bystander laws. Leading concerns for helping a stranger were fear of negative outcomes (41.7%), not knowing CPR (32.6%), and infectious disease (22.1%). In adjusted models, training (aOR 4.28, CI 2.95 to 6.22), prior CPR performance (aOR 5.63, CI 3.38 to 9.38), and law familiarity (aOR 2.00, CI 1.37 to 2.94) were associated with high confidence, while training (aOR 1.58, CI 1.12 to 2.22) and prior performance (aOR 2.44, CI 1.39 to 4.28) were associated with comfort helping a stranger.

While ED patients reported strong interest in CPR training, there were substantial knowledge gaps and outcome related concerns, supporting ED-based training referral plus brief bystander-law messaging. The ED is an underused venue to normalize bystander action; scalable, basic education plus legal reassurance could convert willingness into action and increase CPR starts when minutes matter most.