Starting bystander CPR within 10 minutes of cardiac arrest may improve survival

By American Heart Association News

Liudmila Chernetska/iStock via Getty Images
(Liudmila Chernetska/iStock via Getty Images)

Starting CPR within the first 10 minutes of someone having a cardiac arrest at home or in public may greatly improve their chances for survival and protect their brain function, according to new research.

The study, which will be presented Saturday at the American Heart Association's Resuscitation Science Symposium in Chicago, found people who received CPR within the first two minutes of an out-of-hospital cardiac arrest had the highest chance for survival and for retaining brain function, but that some benefits could still be gained if aid was given within 10 minutes. The findings are considered preliminary until full results are published in a peer-reviewed journal.

"These results highlight the critical importance of quick action in emergencies," study researcher Dr. Evan O'Keefe said in a news release. He is a cardiovascular fellow at Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City. "It suggests that we need to focus on teaching more people how to perform CPR, and we also need to emphasize ways to get help to those suffering cardiac arrest faster."

Those ways might include more widespread CPR training programs, better public access to automated external defibrillators, or AEDs, and improved dispatch systems, he said.

Cardiac arrest occurs when the heart abruptly stops beating. About 350,000 cardiac arrests occur outside the hospital each year in the U.S., with a survival rate under 10%, according to the AHA. CPR from a bystander offers an increased chance for survival by sending blood to the brain and other vital organs.

The new study investigated whether there was a time limit for when bystander CPR would no longer increase a person's survival odds. Using data from the national Cardiac Arrest Registry to Enhance Survival, or CARES, researchers analyzed outcomes for 198,869 witnessed out-of-hospital cardiac arrests that occurred between 2013 and 2022 in people who were an average 64 years old. About two-thirds were men.

Compared to people who received no bystander CPR, those who got it within two minutes had an 81% greater chance of surviving and being discharged from the hospital and a 95% higher chance of surviving without significant brain damage. Even people who did not receive CPR until up to 10 minutes later had a 19% higher survival rate than those who received no CPR. They were 22% more likely to survive without significant brain damage.

About 12% of people who did not receive bystander CPR survived to be released from the hospital and more than 9% had no significant brain damage or major disabilities. People who received bystander CPR more than 10 minutes after a cardiac arrest had no higher chance of survival than people who didn't receive CPR.

Dr. Anezi Uzendu, an interventional cardiologist at UT Southwestern Medical Center in Dallas and a cardiac arrest survivor, said the study underscores how important it is for bystanders to quickly recognize cardiac arrest and act.

"Time is of the essence when a cardiac arrest occurs, and late interventions can be as ineffective as no intervention," Uzendu, who was not involved with the research, said in the news release. "Community education and empowerment are critical for us to save lives."

O'Keefe said the findings "reinforce that every second counts when starting bystander CPR and even a few minutes delay can make a big difference. If you see someone in need of CPR, don't dwell on how long they've been down. Your quick actions could save their life."


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