Dying for a holiday?

So where to from here? If we want to ensure that 33,000 Australians each year have a fair go when they are unlucky enough to suffer a cardiac arrest, we need to do two simple things.

We need mass training of the community in COCPR, so that if a person collapses with SCA every bystander, not just the people who take part in voluntary organisations in their spare time, can recognise the situation and respond by immediately commencing resuscitation and not stopping at all until an AED or an ambulance arrives. CPR or Basic Life Support (BLS) programs need to be ubiquitous, and made obligatory not only for school children, but for everyone else who wants to drive a car, take public transport, pay tax, apply for a passport, and any other means by which we can record their participation.

We also need to get serious about Public Access Defibrillation programs, and strongly encourage federal and state governments, industry, the private and the public sector to work together to develop a strategy which places AEDs in all public areas. Any bystander can operated an AED, as the devices themselves not only will give clear instructions on how to operate them (two sticky pads and one red button), but will also prevent their inappropriate use (on a live person for example). Many of the most successful life-saving schemes in airports and casinos have relied on the intervention of lay bystanders to operate the AEDs.

An AED costs approximately $3-5000 with minimal maintenance, which is the cost of between one and two days occupation of an intensive care bed, or the vast costs associated with the loss of productive, tax-paying members of Australian society. Even the US government have recognised the obvious cost-benefit ratios with the House of Representatives passing the final appropriations bill including $2.5 million for the Health Research and Service Administration's Rural and Community Access to Emergency Devices Program.

We do need to avoid the possibly apocryphal London Underground experience, where AEDs were placed in many stations, but when a passenger was unfortunate enough to suffer his cardiac arrest immediately beneath the device, it was found that the glass case it was kept in was locked, and the key was “in the stationmaster’s office”!

This seems like a tough job, and indeed it will be, but every day we do not bite the bullet, Australians will die in the street of a disease that could be effectively and immediately treated by the Australian standing next to them.