Community leadership. As clinicians we have a wonderful opportunity to educate – not just in the consulting room and on the wards…but also to get out there and make a difference. On 14th Feb (Valentine’s Day) it’s only appropriate that we consider the importance of the heart!
Sudden cardiac death is estimated to affect over 15,000 Australians per year – that’s one person every 26 minutes . Such events are most common in the home…but can also occur in the workplace…or at school or sporting events…type ‘cardiac arrest’ into google or youtube and you will be confronted with images of often fit young people collapsing on the footy pitch, basketball court
…or it can even happen in Ambulance Comms with a TV crew present, as in this video!
Of course most of us think that survival is as portrayed on the TV and films, where ridiculously high success rates on TV belie the fact that survival from out-of-hospital cardiac arrest in this country is less than 10%.
Often even emergency clinicians think that delivering primary health care messages and community training aren’t considered important!
Many people also think that survival depends on ‘hospitals and helicopters’ – expensive machinery, paramedics leaping into action
It’s certainly true that a rapid prehospital system and access to life-saving interventions such as cardiac stenting, cardiac bypass and so on are important…
. …but the first stage in the ‘chain of survival’ requires early CPR and use of a defibrillator.
And that is a problem – typical ambulance response times in the city are around 8 minutes for a ‘priority one’ call…longer in rural areas. Sadly for every minute that goes by, the chances of survival drop by 10%…
We need community members to act as the first links in the chain of survival – to know what to do if someone collapses.
Bystander CPR and Public Access Defibrillators are key
Public education programs such as Vinnie Jones ‘Push Hard and Fast’ or the more recent Australian “Shock verdict’ campaigns can help educate the public in ‘hands only’ CPR and use of an defibrillator.
These simple steps mean that success rates as low as 7% in Australia can be improved to approaching 70% in countries where a ‘HeartSafe Community’ system has been implemented.
Kangaroo Island – Australia’s First HeartSafe Community
This is what we’ve been doing on Kangaroo Island – educating the community in how to deliver ‘hands only’ CPR, encouraging organisations to purchase defibrillators and ensuring that a certain number are made available 24/7 as ‘Public Access Defibrillators’. You can read about HeartSafeKI here.
We have had our first success, a resuscitation on the bowling green – and this encouraged others to get on board, such that Kangaroo Island is now recognised as Australia’s first HeartSafe community and received a shout-out in National Parliament in Feb 2018
Of course many other communities have trained up schools, sports clubs and business members to deliver CPR, and purchased Public Access Defibrillators for their townships. There is even a nascent National Program for HeartSafe Communities run by the Heart Foundation – from little things, big things grow!
AED Registers and Smartphone Apps
The system can be further bolstered by maintaining a register – we do this locally with the HeartSafeKI register, to remind organisations when replacement pads and batteries are due for their defibrillator.
Additional registers of AED locations exist – SA Ambulance has one, meaning that callers can be directed to the nearest available AED.
On a wider scale, free social enterprise ventures such as the GoodSam app are available globally – using smartphone technology to alert off duty CPR doctors/nurses/paramedics or CPR-certified responders to a cardiac arrest in the nearby vicinity BEFORE the ambulance arrives.
So – what can YOU do this Valentines Day?
As a doctor, nurse or paramedic, consider getting involved to make your neighbourhood a ‘HeartSafe’ community .
– if you are CPR trained, please register as a GoodSAM responder.
– if you are able to train others in CPR, then please consider running sessions to train the community in CPR and use of a defibrillator (any doctor should be able to do this!)
– if you are a community leader, help advocate for Public Access Defibrillators to be made available where you live
If you are not clinically trained, but are concerned about the possibility of sudden cardiac death in your school, workplace, sports club or community, then help campaign for training in CPR and a network of Public Access Defibrillators.
You can become a HeartSafe Community by training >10% of residents in CPR and instituting a network of Public Access Defibrillators, integrating into existing ambulance and cardiac care services…
Come on Australia – let’s do this. As clinicians you have a wonderful opportunity to engage in a public health campaign.
Heart Foundation Australia – Sudden Cardiac Death
Sydney Morning Herald – TV Portrayal of Resuscitation Success is Ridiculously High
HeartSafe Communities – the USA HeartSAFE Program
Heart Foundation Australia – HeartSafe Communities
SA Ambulance AED Register – log your AED here
GoodSAM App Crowdsourcing via Smartphone – read more here
Community CPR, It Works! – heartwarming tale from survivor of a sudden cardiac arrest & his rescuers
Kangaroo Island is Australia’s First HeartSafe Community – Parliament statement by Rebecca Sharkie, MP
HeartSafe KI – info on HeartSafeKI program