Reply to: European resuscitation council should have gone further to promote cardiopulmonary resuscitation awareness

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Editor,
Cordial thanks to Dr Ajmal1 for his interesting views and information. It is correct that most – at least 60% – of out-of-hospital cardiac arrests occur at home. And we know that immediate start of basic life support (BLS)–cardiopulmonary resuscitation (CPR) by lay persons increase the survival rates of these patients by two-fold to four-fold.2–4 So, with regard to neurologically intact survival, lay-CPR is much more effective than any other out-of-hospital or in-hospital intervention here.2–4 Therefore, we need to aim for highest lay-CPR rates possible, that is 60 to 80% – not only in public places but also and especially at home.2–4 To reach this most important goal, broad national initiatives are needed. They have already been shown to be very effective in some countries.4 These initiatives should consist of nationwide telephone-CPR, ‘first responder’ programmes,5 schoolchildren education in CPR starting at the age of 12 years,6 and many other approaches to reach and educate all members of the society2–6 – and this should definitely include family members of patients suffering from cardiac diseases. I fully agree that healthcare providers should educate families about BLS in a focused and precise manner, as suggested by Ajmal.1 And when we will have scientific evidence for this – most probably very effective – family members approach, we will bring this much more intensively into the next European Resuscitation Council guidelines on CPR.
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