Cardiopulmonary resuscitation in resource-limited health systems-considerations for training and delivery

Jason Friesen, Dean Patterson, Kevin Munjal

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


In the past 50 years, cardiopulmonary resuscitation (CPR) has gained widespread recognition as a life-saving skill that can be taught successfully to the general public. Cardiopulmonary resuscitation can be considered a cost-effective intervention that requires minimal classroom training and low-cost equipment and supplies; it is commonly taught throughout much of the developed world. But, the simplicity of CPR training and its access for the general public may be misleading, as outcomes for patients in cardiopulmonary arrest are poor and survival is dependent upon a comprehensive chain-of-survival, which is something not achieved easily in resource-limited health care settings. In addition to the significant financial and physical resources needed to both train and develop basic CPR capabilities within a community, there is a range of ethical questions that should also be considered. This report describes some of the financial and ethical challenges that might result from CPR training in low- and middle-income countries (LMICs). It is determined that for many health care systems, CPR training may have financial and ethically-deleterious, unintended consequences. Evidence shows Basic Life Support (BLS) skills training in a community is an effective intervention to improve public health. But, health care systems with limited resources should include CPR training only after considering the full implications of that intervention.

Original languageEnglish
Article number00126
JournalPrehospital and Disaster Medicine
Issue number1
StatePublished - 20 Nov 2014


  • cardiopulmonary resuscitation
  • community health worker
  • low- and middleincome countries
  • medical ethics
  • training


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