Bystander CPR rates reach record high
February 26, 2016in Research
The VACAR Annual Report, released today, found a record 64 per cent of onlookers attempted CPR if they witnessed someone collapse in cardiac arrest. In 2005-06 the rate was 35 per cent.
It also found bystanders used Automated External Defibrillators (AEDs) on patients in a shockable rhythm 70 times in 2014-15, a six-fold increase on the 10 times AEDs were used in 2005-06.
Lead researcher and Ambulance Victoria Research and Evaluation Manager Dr Karen Smith said minutes mattered in cardiac arrest, and the sooner a person received CPR and application of a defibrillator the better their chances of survival.
`Bystanders are the critical first link in the chain of survival and can help keep patients alive before our highly-trained paramedics arrive,’ Dr Smith said.
`Patients who received bystander CPR were much more likely to be found in a shockable rhythm, the cardiac rhythm most favourable to survival.
`But in a third of cases where a bystander sees someone collapse they don’t do CPR. We know any CPR is better than no CPR so we would encourage the community to call Triple Zero for an ambulance and start CPR. The Triple Zero call-taker will provide instructions on how to do this.’
Dr Smith said Ambulance Victoria had a comprehensive research program which aimed to improve patient care and outcomes.
`The VACAR Annual Report is the cornerstone of our research program. It paints a comprehensive picture of cardiac arrest in Victoria and is internationally-recognised,’ Dr Smith said.
`We are one of the few out-of-hospital cardiac arrest registries to routinely follow up on survivors’ quality of life. The report shows 77 per cent of patients who were working prior to their cardiac arrest returned to work within a year.
`Our research program also involves supporting paramedics studying for PhDs and contributing to international journals.’
Despite continued growth in demand for ambulance, the 2014-15 VACAR Annual Report showed:
Emergency responders attended 5,657 out-of-hospital cardiac arrests in the 12 months to 30 June 2015.
Cardiac arrest patients who received an electric shock with an AED were most likely to be discharged from hospital alive if a bystander delivered the shock. Almost half (49 per cent) of patients shocked by bystanders were discharged from hospital alive compared with 40 per cent by first responders and 26 per cent by paramedics. This was mostly likely due to bystanders being early on the scene and time to defibrillation being a critical factor in out-of-hospital cardiac arrest survival.
More than a third (35 per cent) of patients in metropolitan areas who were seen to collapse, found in a shockable rhythm and then received resuscitation by emergency services survived. In comparison, London’s survival rates for people in the same situation is 31 per cent.
Median response times to cases receiving an attempted resuscitation in regional Victoria improved from 11.5 minutes in 13-14 to 10.2 minutes in 14-15, while they remained steady in the metropolitan region at 7.5 minutes.
Ambulance Victoria Acting General Manager Emergency Operations Mick Stephenson said MICA paramedics in Melbourne and Geelong recently starting to carry a mechanical CPR machine was another example of trying to improve cardiac arrest survival rates.
`We are also expanding our Emergency Medical Response (EMR) program to include more Country Fire Authority (CFA) brigades following a successful trial. The program has been in Melbourne for almost two decades and sees trained firefighters and paramedics dispatched to cases simultaneously,’ Mr Stephenson said.
`We are also going to focus on engaging with rural communities to improve early CPR and defibrillation response.
`We’ll use our data and work with stakeholders to identify suitable towns for this initiative, which was recommended in the Ambulance Performance and Policy Consultative Committee report, released late last year.
`There will be 1000 extra AEDs in the community of the next four years, with the first 100 recipients of the government’s defibrillator program for sporting clubs announced earlier this month.
`The community can also purchase AEDs. These machines can save lives and you don’t need any training or special skills to use them.
`If you have an AED make sure you register it with Ambulance Victoria.
Background
A cardiac arrest occurs when a person’s heart suddenly stops beating. A person in cardiac arrest will collapse and stop breathing normally and should receive cardiopulmonary resuscitation (CPR) immediately.
A heart attack occurs when an area of the heart is seriously deprived of blood because of a blocked vessel. The warning signs and symptoms of a heart attack can vary from person to person but often last for at least 10 minutes and may include chest pain and shortness of breath. A heart attack can progress to a cardiac arrest.