A heart charity based in Galway is leading the campaign for quick access to potentially life-saving defibrillators. Theresa Judge reports
If you are one of the 6,000 Irish people who will suffer sudden cardiac arrest out of hospital this year, your chances of staying alive until you reach hospital are just about one in 100.
However, if a person with minimal training armed with a small machine called a defibrillator could reach you within five minutes of cardiac arrest, your chances of surviving would be very good.
These are the basic facts that have inspired Galway-based heart charity Croí to run a high-profile campaign to have defibrillators provided in public buildings, commercial centres, workplaces and sports clubs.
In partnership with the ambulance service of the Western Health Board, Croí is running two different schemes - to put defibrillators into public places, and to provide them to trained groups of volunteers in towns around the western region.
"A defibrillator could be compared to a fire extinguisher - you never know when you might need it, and it mightn't be used for five years, but one day it could save a life," says Neil Johnson, chief executive of Croí.
A defibrillator costs about €3,000. Johnson says this is about as much as a company would spend on one laptop computer. He says that from the Government's point of view, there is an economic argument for providing them. "When you compare it with the amount of money spent on road safety campaigns, and rightly so, there is certainly a strong case for the State to invest in public defibrillators," he says.
The key to surviving cardiac arrest is to get defibrillation within five minutes. The chances of surviving a cardiac arrest decreases by up to 10 per cent with every passing minute. Getting to a victim within five minutes is obviously not feasible for ambulance crews in most areas. Distances in the West mean people can be waiting for up to 45 minutes for an ambulance. While it used to be the case that only medics could perform defibrillation, this is no longer true.
Ray Bonar, chief ambulance officer with the WHB, says that with the new generation of defibrillators, basic training can be completed in about seven hours. Portable "automated external defibrillators" (AEDs) are actually designed for people without medical training.
Significant progress has been made since the joint Croí/WHB ambulance service schemes were initiated last September. In the first scheme, Public Access Defibrillation, four defibrillators have been placed in locations including Galway Shopping Centre and Galway Airport and four more are to be provided before the end of this year. Staff working in each vicinity have been trained. So far one has been used and was in operation within three minutes of the initial call.
Locations chosen reflect research suggesting that there is a high incidence of cardiac arrests in certain locations such as airports, golf courses, sports complexes, shopping centres, casinos, the workplace and on board aircraft, ferries and trains.
In the scheme with local communities - the First Responder Schemes - there are now six of these in locations including Gort, Tuam, Carna and Strokestown, and four more groups are in training.
The team of volunteers in each location undertake a 42-hour first aid training course and are supplied with a defibrillator. They then operate an on-call system and can be bleeped if a cardiac arrest occurs in their area. They are notified by the ambulance service once a 999 call is made.
Bonar says these groups have responded to six cases so far this year and in a number of these, the person was kept alive. But figures would suggest many more defibrillators and trained volunteers are needed. The WHB ambulance service responds to about 30 cardiac calls a week, but the total number of cardiac cases that arrive in hospital each week is about 90.
For Croí, these schemes are another part of the jigsaw of radically improving cardiac care in the West. Since its foundation in 1985, the charity has raised a total of €8 million and there have been some major improvements in services as a result of its fundraising.
A new coronary care unit, to which Croí contributed €250,000, opened in Galway two years ago, and the charity raised €1 million towards having heart surgery provided in Galway. The regional heart surgery unit is now ready for occupation and last month the Minister for Health gave approval for a cardiac surgeon to be appointed.
In 1996, Croí introduced the first coronary care ambulance, with a doctor on board, in the country. It also runs Cardiac Clubs where nurses provide advice and support. The charity was founded, Johnson says, because of "gross inequities" in cardiac services between the east and west of the country.
"In 1985, a person could not even get an angiogram in the West. But inequities remain. There are only two consultant cardiologists in the Western Health Board area and you still have to go to Dublin or Cork for surgery." A surgeon is expected to be appointed within the next year.