Have your next heart attack in Norway. Or Austria. Or Hungary.
Those places require every person who gets a driver's licence to have training in administering CPR and AED (automatic external defibrillater). Many other jurisdictions in Europe and around the globe also ask that their driving public be trained first responders with at least CPR knowledge. It is not so in Canada, and that is unfortunate. We have too many heart attacks and we die in disproportionately large numbers - one every five minutes. In Norway, Austria and Hungary that doesn't happen so much.
If you asked which city was the geriatric capital of Canada, you would probably get "Victoria" more often than not, but t'aint quite so. Parksville gets that distinction, with Sidney by the sea being next in line, and although we can excuse the statistic by saying the populations of those places are just Victorians who didn't like bike lanes, the statistics we can't hide are more significant. Fourteen of us Canadians die every hour from heart disease, which is about one person every five minutes dying from a heart condition or stroke.
We can dissect the statistics and definitions and argue that not all cardiac events or strokes present as the chest-clutching classic picture of a heart attack victim, but people still die from that classic event and they don't have to. Nine in ten of cardiac arrest victims will live if given a shock from an AED within the first minute after the attack. But, their survival chances decrease rapidly in the minutes following. The chart looks like this:
Survival Rates After Cardiac Event
Elapsed time Survival
under 1 min. 80 – 90%
3 – 5 min 50 - 70%
6 – 9min under 10%
The average EMS (emergency medical service) response time in Victoria is nine minutes. Personnel say they try for seven minutes but it is often up to fifteen minutes or longer depending on weather conditions and the odd &^&%*#$* driver who won't get out of their way. Either way, it's much too long for the one suffering the heart attack.
Citizens could be first responders in many cases, especially with training. Norway knows this. With CPR being part of the school curriculum, the average out-of-hospital cardiac arrest survival rate in that country is 25%. With that bystander training and the availability of an AED, survival rates go up even further. It is creating a citizenry trained to be that bystander first response team that gives the advantage - that and the availability of AED devices.
An AED costs about $2000 putting them beyond the category of the naloxone kits which many of us have been trained to carry, and those defibrillaters are not really intended to be portable except by ambulance personnel. They aren't heavy, but it is much better to have them placed in fixed and known locations. At your rec centre they will be in the reception area because at least one of the people on duty there will have been trained to use it. The same will be true in care homes. Your apartment building or condominium will not likely have one anywhere and it's not just a matter of cost.
You can have all the equipment of an intensive care unit, but if no one knows what to do with it, you'll die. Education is key and it's expensive. I phoned around Victoria and found CPR/AED training courses for $100. That may be justified as an expense given instructor skill, venue and training equipment, but it still is beyond what most of us would be willing to pay, and I think part of the hesitation has to do with the association of the training with the application.
First responders are the ones who move toward catastrophe when the rest of us instinctively move away. That's where training is critical. We need to know what to do with enough confidence to overcome the avoidance instinct. In one group of volunteers at a community recycling project who responded to my query about their knowledge of AED application, only one had received training and she noted that her class had been told that regardless of outcome, if they were ever called upon to use their skills, they would need some counselling to debrief after the event.
So, how do we normalize a citizen first-response situation? We start by asking for assistance and pressing for solutions. These are some of the questions to ask:
Where is the nearest AED to you?
Does the restaurant you frequent have an AED?
Does a staff member at that restaurant know CPR or AED use?
If in an apartment or condo, how can you get one?
Who will pay for and who will maintain the equipment?
Who will be trained to use the AED?
Who will pay for that training?
If you are one of the people reading this op-ed and you know the answer to one of these questions, please tell us. A life may depend on it. Maybe yours.