The Department of Health deserves a round of applause for moving to amend the Emergency Medical Service Act (緊急醫療救護法) to make it mandatory for public facilities of a certain size to have portable Automated External Defibrillators (AEDs), and to exempt trained and untrained rescuers from legal liability if their efforts to save a life result in injury or death. These measures would go a long way in helping save lives, but there is more that could be done.
The department says 200,000 cardiac arrest patients are admitted to emergency rooms in Taiwan each year. The proposed amendments are aimed at encouraging bystanders to help if they see someone having a heart attack or who is injured.
Studies in the US, including one by doctors at the University of Washington, have found that more than 92 percent of people who suffer sudden cardiac arrest outside of hospitals do not survive to hospital discharge, and survival declines by 7 to 10 percent for each minute defibrillation is delayed.
A greater availability of AEDs — which are designed to be used by laypeople and provide verbal instructions for each stage of operation — have been proven to increase the survival rate of cardiac arrest victims. The devices monitor heart rhythms and administer electric shocks to restore a normal heartbeat.
The health department is encouraging private companies, universities and other organizations to buy AEDs and train their staff in emergency rescue procedures. However, AEDs should also become required for all schools — because children as well as adults can be victims of sudden cardiac arrest — as well as at beach lifeguard stations. The private sector, both business and civic organizations, should be encouraged to chip in to provide AEDs for facilities that can’t afford to buy them on their own.
However, AEDs alone are not enough; there has to be someone who can perform cardio-pulmonary resuscitation (CPR) as well. Greater efforts are needed nationwide to get the message across that people of all ages and all walks of life can learn CPR — and use it, as well as other basic life-saving skills..
In September 2007, the then-Taipei County Government sponsored a CPR training drill — an attempt to break a Guinness world record for the simultaneous performance of CPR — that drew 3,249 people, ranging in age from four to 97, as a way to mark the opening of the country’s First Aid Promotion Center. Then-Taipei County commissioner Chou Hsi-wei (周錫瑋) gave a sobering statistic in his speech at the event: Only 10 percent of attempts to save someone with CPR are successful in Taiwan, compared with 40 percent in the US.
Part of that 10 percent rate is certainly because too many people wait for an ambulance or fire department personnel to arrive and perform emergency rescue procedures, including CPR.
The Red Cross Society of the Republic of China offers classes in CPR and basic first aid and has trained tens of thousands of people since 2004. It is already working with the health department to promote CPR plus AED training. Many universities provide CPR classes for freshmen; schools at all levels should do the same.
Mary Newman, president of the Sudden Cardiac Arrest Foundation in the US, devised the “Cardiac Chain of Survival” metaphor in 1988. The chain — early access, early CPR, early defibrillation and early advanced cardiac life support — is one that everyone in Taiwan should know and support.