Experts Urge Action on Increasing Mortality Rates for Australian Cardiac Arrest Victims

Critical Care and Resuscitation journal study finds a problem in New South Wales


 
 

STEPHANIE CARPER, STAFF, ABC Premium News | | Wednesday, September 25, 2013


Residents in New South Wales who suffer cardiac arrest outside of hospital face the lowest survival rates in a decade, according to a major new study.

Published today in emergency medicine journal Critical Care and Resuscitation, the study found that while fewer people suffer out-of-hospital cardiac arrest, those that do in NSW are more likely to die.

According to the study, of the 3,800 people that experience cardiac arrest each year in the state, only 10 per cent survive.

The mortality rate is almost ten times than that of road accidents.

Clinical associate professor Paul Middleton, chair of the Australian Resuscitation Council NSW, says the results are "extremely disappointing".

"We are frustrated with these results because we know the problems have simple solutions, which have been shown to be successful and are straightforward to implement," Professor Middleton said.

He says with mortality rates for cardiac arrest are falling both interstate and overseas, NSW is "at real risk of being left behind".

"Cardiac arrest is one of our biggest killers and to find out that we are going backwards is unacceptable."

Training the community

Professor Middleton draws a stark contrast to the state's mortality rates with Seattle, United States, where more than 50 per cent of out-of-hospital cardiac arrest victims survive.

He says survival rates could be dramatically increased if the city's range of preventative and emergency measures, including community-wide free CPR training, widespread placement of publicly accessible defibrillators and cardiac arrest registry, were implemented.

"Some of the measures that are in place in Seattle are also in place in Victoria, Queensland and Western Australia but not in New South Wales," he said.

"We have no organised method to collect data in patients who have had cardiac arrest, even though it's a disease carrying a 90 per cent mortality rate.

"It sounds very basic, but it's been shown in Seattle that training the whole community in cardiac arrest response vastly increases the survival rate."

The measures would be successful in raising the mortality rate given that they concentrate on the first, most critical minutes of a cardiac arrest, he says.

"If your heart stops [in a cardiac arrest], you literally have 3-4 minutes before your brain suffers irreversible brain damage from lack of oxygen," he said.

"The fastest ambulance could not get there in that time frame, and therefore, if you don't have bystanders who know CPR, the person suffering the cardiac arrest will die."

Defibrillation is critical

Professor Middleton says defibrillation, which if delivered quickly can increase survival in victims by up to 75 per cent, "should be everywhere and in every public place".

"We already know we have an efficient ambulance service with response times reasonably comparable to ambulance services in Seattle," he said.

"If we had a system to put those things in place then I don't see any reason whatsoever why we shouldn't have a similar survival rate to Seattle's."

The State Opposition's health spokesman Andrew McDonald agrees defibrillators should be more widespread in the community.

He says the devices are common in shopping centres and on train stations in Europe.

"The more these defibrillators are available the more they will be used," he said.

"People do need to be shown how to use them. They're quite easy to use but you need to be shown how to do it first.

"But we know that the more defibrillators you've got the better your chances of survival of cardiac arrest."

In a statement, NSW Ambulance says paramedics are highly trained in use of equipment to treat cardiac arrests and members of the public can seek training through a number of avenues.

"The community have access to a vast range of CPR courses and training, available through a number of organisations, clubs or private providers," the statement read.

"Additionally, CPR training is now a compulsory part of the Year 7 to 10 high school curriculum for students."

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