Tuesday, November 12, 2013

Pedestrian Deaths Fatalities Preventable Deaths Cardiac Arrest Deaths Brisbane Times 25.9.13 Community Safety

Change of heart vital to stopping needless cardiac arrest deaths

Paul Middleton September 25, 2013

"If you have a cardiac arrest, you're more likely to die than you were in 2005." Photo: Janet Briggs
Doctors like saving lives. We don't like unnecessary deaths. That is why the results of a new study into out-of-hospital cardiac arrests in NSW are so frustrating - the medical profession knows what needs to be done to reduce the number of deaths.
The study found that if you have a cardiac arrest, you're more likely to die than you were in 2005. While the incidence of cardiac arrest has dropped, so have survival rates. So you're slightly less likely to have a cardiac arrest now but slightly more likely to die if you do.
There are three measures that need to be put in place to save lives.
One, a statewide, free-of-charge CPR training program that empowers more members of the community to perform CPR. Ordinary people often say they are reluctant to perform CPR because they are afraid they will harm the patient further, but how family members and onlookers respond in those first few vital minutes can be the difference between life and death. To survive a cardiac arrest, a patient must receive CPR or defibrillation within the first 10 minutes but the median response time for ambulances across Australia is between 7½ and 10 minutes.
Second, we need to install a network of publicly accessible defibrillators throughout NSW. Defibrillation is most effective if it is carried out within three minutes of going into cardiac arrest and certain types of cardiac arrest respond only to defibrillation. If it is delivered quickly, up to 75 per cent of patients can survive. Yet only 2 per cent of people who suffer sudden cardiac arrest in public are treated with a defibrillator by a bystander, due to liability concerns and lack of availability and training.
A defibrillator network might sound like a herculean task but it's not. This type of program is already well under way in Victoria and Queensland. Mapping technology means triple-0 operators can guide callers to the nearest defibrillator and talk them through how to use it.
Both of these measures will save lives and that's why the Australian Resuscitation Council NSW is calling on the NSW government to support and fund them - urgently.
The third measure is the establishment of a government-mandated cardiac arrest registry. Doctors, paramedics and researchers can't improve survival rates if we don't know where the problems lie. A register of all cardiac arrests across NSW and the degree of success of treatments received will enable us to spot opportunities for improvement, allowing us to pinpoint the exact areas where we should focus resources.
Each year, about 3800 people have a cardiac arrest in NSW. A staggering 90 per cent of them don't survive. But, with these three measures in place, we can drastically improve the survival rates across NSW. We can save lives.
In the US city of Seattle, 48 per cent of out-of-hospital cardiac arrest victims survive. This is almost five times better than the rate in NSW.
Seattle has achieved this impressive feat by providing extensive CPR training to the public, rolling out a network of publicly accessible defibrillators and creating a cardiac arrest registry; the same measures the Australian Resuscitation Council NSW is asking to be implemented here.
Cardiac arrest accounts for 10 times more fatalities than road deaths. Yet while the road accident toll has been slashed in recent decades, cardiac arrest survival rates remain worryingly static. Our success in reducing road deaths shows what a tremendous impact a concerted, targeted and well-resourced public health campaign can have.
We know what we need to do to reduce hundreds of needless deaths each year from cardiac arrest. Now we just need the support of the government to do it.
Associate Professor Paul Middleton is chairman of the NSW branch of the Australian Resuscitation Council and a specialist in emergency medicine. The report Cardiac Arrests in NSW is released on Wednesday.


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