How to double the survival rate from cardiac arrest

How to double the survival rate from cardiac arrest
Smart national planning could double the survival rate from cardiac arrest in Australia, and enable an extra 2400 people to return home to their families every year, according to an analysis in the Medical Journal of Australia.

Each year at least 20,000 Australians go into cardiac arrest outside of hospital. Their hearts suddenly stop beating and only 12 per cent survive.

This could increase to 24 per cent with the introduction of a national register of publicly available defibrillators, backed by countrywide awareness campaigns and public safety legislation, according to the analysis led by Dr Elizabeth Paratz of Melbourne’s Baker Institute.

“One of the biggest problems is bystander confidence,” said Greg Page, a former member of the Wiggles and an unusual co-author of a medical analysis.

“People think they need training. They don’t because once turned on, the device talks them through the process,” said Mr Page, who has dedicated the past three years to increasing survival from cardiac arrest.

making CPR education mandatory in schools, and conditional on getting a driver’s licence. It also increased the number of publicly accessible defibrillators.

“We need the federal government to invest in national health campaigns and a national register of defibrillators, with appropriate software, so everyone knows where to find one in an emergency. Currently, it’s ad hoc, with no consistency between states.”

Last year South Australia became the first state to mandate the public provision of defibrillators. In Victoria alone, there are 15,000 unregistered defibrillators.

Mr Page’s charity, Heart of the Nation, has begun registering devices but cannot do it alone. It said national legislation was also needed to make vandalising a defibrillator a criminal offence.

The charity’s other initiatives include creating neighbourhood groups with assigned responders, and using stickers on doors to alert people there’s a defibrillator inside.

“But we need greater co-ordination. You see, cardiac arrests aren’t courteous and can happen after hours, when that is door is locked.”

Cardiac arrest costs the economy $35 billion a year, largely in lost productivity, Mr Page said.

“Then there’s the emotional and social cost. I’ve had 3½ extra years with my family because someone pushed that button.”

The analysis suggests survival could increase fourfold when a cardiac arrest is witnessed, the patient’s rhythm is shockable, there is a defibrillator nearby and a bystander is prepared to use it.

But of the 400 cardiac arrests across Australia each week, only nine people were defibrillated by a bystander, said co-author Professor Garry Jennings, chief medical adviser at National Heart Foundation.

“Of the nine, probably seven would be a trained member of public or professional, such as a nurse passing by.”

He said 30 per cent of Australia’s residents were born abroad and a paper just published in the British Medical Journal, which he co-authored, concluded that culture-specific training may improve their confidence and willingness to become responders.

As 70 per cent of cardiac arrests occur at home, usually overnight, it is often difficult to access a defibrillator.

In some parts of the UK, devices are housed in public phone boxes around which small neighbourhood networks have been created.

Professor Jennings said a new type of hand-held defibrillator, the size of a mobile phone, “can be invaluable” to those at high risk of a cardiac event.

“These personal devices provide another option to the box on the wall and have considerable merit.”

The world’s first hand-held personal defibrillator was invented in Australia by medtech start-up Rapid Response Revival.

Called the CellAED, it costs $499, weighs 450g and is highly portable with a two-year battery life. It can be applied in seconds.