Out of hospital cardiac arrest (OHCA) survival data for Australia and New Zealand always makes for difficult reading……….

In 2018, there were 22,826 OHCA cases submitted to the Epistry (17,301 in Australia and 5,525 in NZ) with an overall crude incidence of 104.5/100,000 population (Australia:101.8/100,000 population, NZ:114.1/100,000 population).

Of these, 17,459 (76%) cases had a presumed medical cause: 65% were male, 80% occurred in the home, 37% were bystander or paramedic witnessed, 36% received bystander CPR, 2.7% received bystander defibrillation and 20% were in a shockable rhythm on arrival of paramedics (1).

The survival rates for out-of-hospital cardiac arrest in Australia and New Zealand vary depending on several factors, such as the location of the cardiac arrest, the response time of emergency medical services, and the availability of medical treatment.

It’s worth noting that early recognition of cardiac arrest, early CPR, early defibrillation, and early advanced life support are key factors that can greatly increase the chances of survival from out-of-hospital cardiac arrest. Therefore, it’s important to learn basic life support skills and have access to defibrillators in private and public places to help increase survival rates.

Ambulance response times:

In 2020-21, the time within which 50 per cent of first responding ambulance resources arrived at the scene of an emergency in code 1 situations:

In capital cities ranged from 9.0 to 13.8 minutes, increasing to between 14.7 to 34.4 minutes for 90 per cent to respond.

State-wide ranged from 9.0 and 14.0 minutes, increasing to between 14.7 to 33.4 minutes for 90 per cent to respond (2).

Bearing in mind how busy the roads are especially in metropolitan areas, these response times are impressive, also when you take the size and scale of rural and remote Australia into consideration. But the key here is recognising that it will take a minimum of 14 minutes to get a team of highly skilled clinicians to the patient.

Some key take aways from the above data should be:

1. Most OHCA events occur in the home or at a private residence, 2. Only 36% of people received by stander CPR, 3. Only 2.7% received bystander defibrillation. 4. Ambulance response times can vary

What should the government do to increase the number of public access defibrillators in our communities, including helping people learn CPR?

There are several actions that the government can take to increase the number of public access defibrillators (PADs) in our communities, including:

Mandate PADs in public places: The government can mandate that public places such as schools, government buildings, shopping malls, and airports must have at least one PAD on the premises. This will ensure that PADs are readily available to people in case of a sudden cardiac arrest.

Provide funding for PADs: The government can provide funding for the purchase and installation of PADs in public places. This funding can come from various sources such as grants, donations, or a percentage of fines collected for certain violations.

Provide tax incentives: The government can provide tax incentives for businesses and individuals who purchase and install PADs in public places. This can encourage more people to invest in PADs and help increase their availability.

Increase awareness: The government can launch a public awareness campaign to educate people about the importance of PADs and how to use them. This can be done through various channels such as TV and radio ads, social media, and community outreach programs.

Support training programs: The government can provide support for training programs that teach people how to use PADs and perform CPR. This can include providing funding for training courses, creating incentives for businesses and individuals to participate in training programs, and partnering with local organizations to provide training.

By implementing these strategies, the government can increase the availability of PADs in our communities as well as train more people in CPR and help save lives in the event of a sudden cardiac arrest.

A big shout out to all of the ambulances services across Australia and New Zealand, First Responders, Community Groups/Volunteers, like minded people and survivors, who are using their stories to inspire all of us into taking action.

1. Epidemiology of Out-of-Hospital Cardiac Arrest (OHCA) in Australia and New Zealand: Results From the Aus-ROC OHCA Epistry 2021 https://www.sciencedirect.com/science/article/abs/pii/S1443950621008775

2. Report on Government Services 2022 PART E, SECTION 11: RELEASED ON 1 FEBRUARY 2022 https://www.pc.gov.au/research/ongoing/report-on-government-services/2022/health/ambulance-services