The impact of alcohol use on the quality of cardiopulmonary resuscitation among festival attendees: A prespecified analysis of a randomised trial

Background: Cardiac arrests often occur in public places, but despite the undisputed impact of bystander CPR, it is debated whether one should act as a rescuer after alcohol consumption due to the perceived adverse effects. We provide the first objective data on the impact of alcohol levels on CPR-skills. Methods: Pre-specified analysis of a randomised study at the Lowlands music festival (August 2019, the Netherlands) on virtual reality vs face-to-face CPR-training. Participants with an alcohol level >= 0.5 parts per thousand (WHO-endorsed cut-off for traffic participation) were eligible provided they successfully completed a tandem gait test. We studied alcohol levels (AL, parts per thousand) in relation to CPR-quality (compression depth and rate) and CPR-scenario performance. Results: Median age of the 352 participants was 26 (22-31) years, 56% were female, with n = 214 in Group 1 (AL = 0 parts per thousand), n = 85 in Group 2 (AL = 0-0.5 parts per thousand) and n = 53 in Group 3 (AL >= 0.5 parts per thousand). There were no significant differences in CPR-quality (depth: 57 [49-59] vs 57 [51-60] vs 55 mm [47-59], p = 0.16; rate: 115 [104-121] vs 114 [106-122] vs 111 min(-1) [95-120], p = 0.19). There were no significant correlations between alcohol level and compression depth (Spearman's rho -0.113, p = 0.19) or rate (Spearman's rho -0.073, p = 0.39). CPR-scenario performance scores (maximum 13) were not different between groups (12 (9-13) vs 12 (9-13) vs 11 (9-13), p = 0.80). Conclusion: In this study on festival attendees, we found no association between alcohol levels and CPR-quality or scenario performance shortly after training.