The frequencies of autonomous bystander-initiated cardiopulmonary resuscitation (CPR) and public access defibrillation have not yet been clarified. We aimed to evaluate the frequency of autonomous actions by citizens not having a duty to act.

This retrospective observational study included patients who suffered an out-of-hospital cardiac arrest (OHCA) in Tokyo between January 1, 2013 and December 31, 2017. The Delphi method with a panel of 11 experts classified the locations of OHCA resuscitations into 3 categories as follows; autonomous, non autonomous, and undetermined. The locations determined as autonomous were further divided into 2 groups; home and other locations. Bystander-initiated CPR and application of an automated external defibrillator (AED) pad were evaluated in 43,460 patients with OHCA.

Group A (non autonomous), group B (autonomous, not home), and group C (home), consisted of 7,352, 3,193, and 32,915 patients, respectively. Compared with group A, group B and group C had significantly lower rates of bystander-initiated CPR (group A, B, C; 68.3% versus 38.6% versus 23.9%) and AED pad application (groups A, B, C; 26.8% versus 15.1% versus 0.6%). In addition, multivariate analysis demonstrated that an autonomous location of resuscitation was independently associated with the frequencies of bystander-initiated CPR and AED pad application, even after adjusting for age, sex, and witness status.

Autonomous actions by citizens were unacceptably infrequent. Therefore, the education and training of citizens is necessary to further enhance autonomous CPR.

自主旁观者启动的心肺复苏 (CPR) 和公共除颤的频率尚未明确。我们旨在评估没有义务采取行动的公民自主行动的频率。

这项回顾性观察性研究纳入了 2013 年 1 月 1 日至 2017 年 12 月 31 日期间在东京发生院外心脏骤停 (OHCA) 的患者。 Delphi 方法由 11 位专家组成，将 OHCA 复苏的位置分为 3 类如下; 自主的、非自主的和不确定的。确定为自治的位置进一步分为2组；家和其他地方。在 43,460 名 OHCA 患者中评估了旁观者启动的 CPR 和自动体外除颤器 (AED) 垫的应用。

A 组（非自主）、B 组（自主，非家庭）和 C 组（家庭）分别由 7,352、3,193 和 32,915 名患者组成。与 A 组相比，B 组和 C 组的旁观者启动 CPR（A、B、C 组；68.3% 对 38.6% 对 23.9%）和 AED 垫应用（A、B、C 组；26.8%）的比率显着降低15.1% 与 0.6%）。此外，多变量分析表明，即使在调整了年龄、性别和目击者身份后，自主复苏位置与旁观者启动的 CPR 和 AED 垫应用的频率独立相关。

公民自主行动的频率极低，令人无法接受。因此，公民的教育和培训对于进一步增强自主心肺复苏术是必要的。