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Making Everyone a Lifesaver

The way ahead is making everyone a lifesaver.

Professor Gavin Perkins, Warwick Medical School, Warwick

Sudden cardiac arrest describes the situation where the heart suddenly stops.  The person lapses into a coma within seconds, and if treatment isn’t started within minutes, that individual will die.  It is one of the most lethal medical emergencies that exists.

As an intensive care and ambulance doctor, I see the devastating consequences of out of hospital cardiac arrest as part of my clinical practice almost daily.  The impact of cardiac arrest extends way beyond the person directly affected and includes family, friends and others who are close to the person.

It is frequently said if you don’t measure something, you can’t improve it. By understanding the impact of cardiac arrest, we have a baseline from which we can work to improve outcomes for patients.

We hoped to gain a better understanding about how common cardiac arrest is in the UK, who it affected, how members of the community help with treatments like bystander CPR and public access defibrillation, what treatments are provided by the NHS and how many people survive following a cardiac arrest. By better understanding the condition, we hoped that by working with the NHS, charities and communities we could improve outcomes from cardiac arrest and save more lives.

By working with Association of Ambulance Chief Executives, we set up the national out of hospital cardiac arrest registry.  The registry receives information securely from ambulance services about who has sustained a cardiac arrest, what treatments they receive and how many survive.  We then link information with NHS Digital to learn more about the condition. The work is funded by the British Heart Foundation, Resuscitation Council UK and the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands.

We identified that over 35,000 people sustain a cardiac arrest each year in England and only around 1 in 10 people survive a cardiac arrest in the UK, lower than in many other countries such as Denmark, Norway and parts of the USA. There are also health inequalities in how likely someone is to sustain a cardiac arrest and receive lifesaving treatment from people in their community, with people from lower income and ethnic minorities being most disadvantaged.

Every minute without CPR and defibrillation of the heart reduces the chance of survival by up to 10%. Early CPR and defibrillation double someone’s chances of survival. Both of these can be done by a member of the public before the ambulance service arrives. So, we have been working with charities to develop media campaigns to train members of the public in the lifesaving skills of CPR and how to use a defibrillator. And we are working with NHS England and charities to identify areas that need targeted CPR training and better access to defibrillators.

Tackling this type of challenge requires a unique combination of facilities and expertise. Warwick Clinical Trials Unit is the UK’s largest trials unit supported by the National Institute for Health Research, and its staff were vital in providing the specialist knowledge and expertise to build and manage a database of confidential patient information. That and the clinical expertise of colleagues within Warwick’s emergency, pre-hospital, perioperative and critical care teams have given us the means to tackle the most important and pressing questions that have the potential to save most lives.

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