St John’s latest Out of Hospital Cardiac Arrest (OHCA) report confirms the emergency ambulance service has maintained a strong 16% survival rate for patients who are treated for cardiac arrest.
Numbers to survive a cardiac arrest are universally low. Of the approximately 40 people treated for cardiac arrest by St John each week, 12 are successfully resuscitated and transported to hospital and only six will later survive to be discharged.
The new OHCA data confirms St John’s clinical processes continue to be of a high standard and compare favourably with similar ambulance services internationally.
St John measures its performance against its previous data and other ambulance services including Wellington Free Ambulance Service which has a 14% survival rate, Ambulance Victoria in Australia with 10%, and London Ambulance Service in the United Kingdom, which has a 9% survival rate.
“This is positive for New Zealanders and reflects highly on the skills of our ambulance officers,” says St John Medical Director Dr Tony Smith.
Benchmarking outcomes from cardiac arrest data is one of the key clinical quality measures of an emergency ambulance service and is fundamental to improving outcomes for New Zealanders.
It takes an entire system to save a patient in cardiac arrest – starting with community and bystander response, Clinical Control Centres, New Zealand Fire Service (NZFS) and other co-responders, through to advanced life support from ambulance service and hospital personnel.
“St John is working to improve patient outcomes by focusing on factors that affect this system or ‘chain of survival’,” says Dr Smith.
Approximately 1500 people die following cardiac arrest every year in New Zealand - a number five times higher than the national road toll.
“Death from cardiac arrest is our ‘silent toll’. It can happen to anyone of any age, including children. We remain focused on reducing this toll, but we can’t do it alone. We need all New Zealanders to help by knowing how to do CPR and use a defibrillator (or AED),” says Dr Smith.
A cardiac arrest is allocated the highest (Purple) response and the closest responder is immediately dispatched but it is bystanders who need to initiate the ‘chain of survival’ with immediate recognition, early CPR and rapid defibrillation.
“For every minute without CPR or defibrillation, a patient’s chance of survival falls by 10-15%,” says Dr Smith.
The data in this and previous reports confirms that Māori are at higher risk than non-Māori of cardiac arrest and as a result St John developed the ‘Marae Out of Hospital Cardiac Arrest programme’. St John Pou Takawaenga (Māori liaison officers) have been working with Māori communities and maraes across NZ since early 2016 to support training and access to defibrillators and CPR.
At the same time St John introduced its 3 Steps for Life community programme which trains people to take three key actions when someone has a cardiac arrest. St John hopes to see the positive effects of these initiatives in subsequent reports.
But New Zealand’s low rate of public access to defibrillators remains an issue. While 60% of patients had bystander CPR performed, only 6% of patients were defibrillated using a public access defibrillator (or AED).
St John’s key partner ASB installed AEDs throughout their branches nationwide in 2015 and another partner Z Energy recently completed a similar initiative.
- The most common cause of cardiac arrest is heart disease (77%) and heart disease is the second most prevalent cause of death in New Zealand
- 67% of cardiac arrests occur at home and 21% happen in public
- Of the patients in cardiac arrest attended by St John, 68% were male and 32% female - the overall incidence rate for males is more than double that of females
- The average age of males was 63 years and females was 67 years
- Māori were disproportionally affected with a higher incidence of cardiac arrest (114.1) compared with all other ethnic groups (less than 80) per 100,000 years
- Applying CPR and using an AED can increase a patient’s chances of survival by up to 40%
- 70% of cardiac arrest incidents were co-responded by New Zealand Fire Service. NZFA was first on scene for 15% of incidents and was fundamental in the defibrillation of 95 patients; 38% survived to hospital handover and 28% survived to hospital discharge
The OHCA report is available on the St John website http://www.stjohn.org.nz/globalassets/documents/news-info/ohca-report-2016-lq.pdf
St John has developed free awareness sessions, on line videos and a smart phone application for the public to learn how to do CPR and use an AED:
- A 3 Steps for Life awareness session introduces members of the public to basic lifesaving skills for people in cardiac arrest http://www.stjohn.org.nz/What-we-do/Community-programmes/3-steps-for-life
- Download the St John CPR Mobile App
- Learn how to do CPR and use an AED (defibrillator)
- St John provides First Aid Courses to the public
- St John supports the AED Locations App which finds the nearest public defibrillator available (throughout New Zealand)
FOR FURTHER INFORMATION CONTACT:
St John Media & Public Relations Manager
T 09 526 0528 I X 7877 I F 09 526 0553 | M 021 605 342
NB cardiac arrest should not be confused with heart attack.
- What is cardiac arrest?
A cardiac arrest occurs when the heart stops beating and often happens suddenly and without warning. No blood is pumped to the brain and seconds later the person will lose consciousness and stop breathing. Death occurs within minutes if the person does not receive CPR and emergency treatment. The most common cause of cardiac arrest is a heart attack, but there are other causes including drowning and electrocution.
- What is a heart attack?
A heart attack occurs when a blocked artery stops blood from reaching a section of the heart. If the blocked artery is not reopened quickly, the part of the heart supplied by that artery begins to die. The longer a person goes without treatment, the greater the damage. Symptoms of a heart attack include chest discomfort that may go into the arms, neck or jaw. Most patients having a heart attack will not have a cardiac arrest.