Confusion Causes Hesitancy in Emergencies

A new study has found that confusion, not stress, causes people, even those trained in cardiopulmonary resuscitation (CPR), to hesitate in taking action when an emergency unfolds in front of them.

Researchers from several universities and health centers surveyed 1,243 lay people trained in CPR who took part in the study. While most of the respondents said they experienced low stress levels when faced with responding to a person in medical distress, the study found that laypersons responding to situations thought to be heart attacks had higher stress levels than those involved in other events. Stress levels were also higher in residential than in public settings.

Many of the respondents indicated that practical issues concerned them more than their own emotions. Concerns included barriers to responding, such as communication with confused and combative patients; skills such as accessing airways or taking accurate pulse checks; accessing the victim in awkward, dark, or cramped areas; and dealing with the characteristics of the victim and the situation, such as bleeding, jerking, vomiting, age, and size. Respondents who did indicate high stress levels tended to be women and non-native English speakers. Younger people also reported higher levels of stress in response situations. The study was published in the July 2006 issue of the journal Resuscitation.

"Lay responders really do need to talk to someone who has been there to put it into perspective and calm down,” said Dr. David Feeny, co-author of the study and a professor of public health sciences at the University of Alberta (Edmonton, Canada). "We train them to perform a physical skill, but not how to handle the grief of the family and their own feelings. These can be horrendous situations.”

In order to help lay responders deal better with these issues, the researchers suggest communities do two things: develop a system to track lay responders after an incident so they can be offered counseling; and secondly, offer debriefing for volunteers who take CPR courses, as is done for professional medical emergency responders.



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