November 30

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Pump Hard and Fast

Typically 10% of people who suffer from cardiac arrests outside a hospital will survive.  The survival rate is improved to 35% if a bystander witnesses the event, calls for an ambulance and performs CPR (cardiac pulmonary resuscitation).  Last year, the median arrival time for ambulances in Victoria was 7.8 minutes.  Every minute where CPR is performed increases the patient survival rate.  In Victoria, approximately 8,000 people suffered heart attacks outside of hospital each year, with 75% occurring in private homes.  Increasing the number of the bystanders who perform CPR will increase the odds of patient survival.

I attended a workshop at Ambulance Victoria this week where experts and non-experts (me) were invited to brainstorm ideas of how to increase the number of general public members performing CPR if they witness a cardiac event.  Save the Children was invited as part of the emergency preparedness and response planning community.  I participated as a complete outsider with no previous experience.  I happily joined unaware of how much I would learn in a single day’s session, both in terms of content and process.

I have taken various CPR training sessions over the years.  The recommendations have evolved and changed during that time.  The current recommendations for CPR for the general public is chest compressions only without any breaths.  This surprised me as it was 28 compressions and 2 breaths when I took infant / child CPR about 8 years ago; and 4 compressions and 1 breath when I first completed my first aid training when I started working as a pharmacist.  Organizations are now moving away from formal training and certifications and providing 60 second awareness sessions instead.  I learnt in less than a minute to look and feel for the breath (no need to search for a pulse), then if the patient is not breathing, start chest compressions.  The chest compressions need to be hard and fast.   Breaths are not needed.  You just need to keep the blood pumping to the brain until the ambulance arrives.  Also, that you can do no harm – broken ribs are better than the alternative.  Most importantly, doing something is better than doing nothing.  Everyone can perform CPR, from kids over 12 years old to the elderly.  If CPR is needed on a child – use 1 hand.  If CPR is needed on an infant, use 2 fingers.

The workshop was hosted by Ambulance Victoria and facilitated by Behaviour Works Australia (Monash University).  I received an amazing crash course in behavior change.  The facilitators gave us a quick background on behaviours and the various types of drivers influence behaviours.  We then used a specific methodology to identify specific barriers to the desired behavior (performing CPR).  By understanding the type of drivers, the solutions developed to overcome the barriers can be tailored to improve the chances of the desired behavioural change.  We focused on four different contexts – at school, at home, on the street and in the workpace.  The barriers differed according to the context, so different solutions are needed, rather than a general one size fits all approach.  I was so impressed with this methodology that I had started planning to use it for my current role at Save the Children before I left the session.