By Dr. Edmund Harrison (guest opinion)
The Heart and Stroke Foundation extends its appreciation to Chris Robinson for his thought-provoking commentary in the December 30 issue of The Guardian around the issue of low survival rates in P.E.I. following sudden cardiac arrest.
To avoid any confusion arising from Mr. Robinson’s use of the terms heart attack and sudden cardiac arrest, it is important to note that these terms are not interchangeable: a heart attack occurs when blood flow to a part of the heart is blocked, whereas in sudden cardiac arrest the heart has unexpectedly stopped beating. Signs of cardiac arrest include no breathing or only gasping, no movement, and no pulse.
We also welcomed comments on Mr. Robinson’s article in the The Guardian and the Journal-Pioneer by Desmond Colohan, Provincial Chief Coroner. Dr. Colohan takes issue with Robinson’s statement that P.E.I.’s survival rates for out of hospital cardiac arrest are worse than those in other areas. Colohan references information from the American Heart Association journal, Circulation, on the “worldwide lack of significant improvement in cardiac arrest survival rates” over the past 30 years. He also correctly states that “In most cardiac arrests, the weak link is prompt bystander CPR.”
Eighty per cent of sudden cardiac arrests occur outside of hospitals, and less than five per cent of these individuals survive. The chance of survival is doubled when CPR is started immediately followed by prompt use of an automated external defibrillator (AED). And this is where P.E.I., indeed all of Canada, does lag significantly behind other countries.
Currently in Canada, bystander response rates for cardiac arrest are in the thirty to forty per cent range.
Other countries have rates of fifty to sixty per cent.
As most of your readers will know, the Heart and Stroke Foundation is committed to promoting public training in bystander CPR and access to AEDs in public places. With the help of our partners, we work to ensure that all Islanders, regardless of their location, receive the same excellent care, from bystander response to early defibrillation through to advanced pre-hospital care.
With the recent installation of new digital communications equipment in all P.E.I. emergency vehicles it is hoped that response times for cardiac and other emergencies will be reduced and lives saved. However, the reality is that in a province subject to severe winter weather and with a largely rural population, immediate CPR combined with the use of an AED in concert with the prompt activation of Emergency Medical Services offer the best chance of saving a life in the event of a cardiac arrest.
The Heart and Stroke Foundation encourages all Canadians to get trained to apply CPR and AED skills when needed.
We continue to work with governments, other volunteer organizations, Island communities and dedicated volunteers to ensure the accessibility of these essential emergency care measures.
To find a CPR course near you visit heartandstroke.ca/heroes
Dr. Edmund Harrison is a board member of the Heart and Stroke Foundation, P.E.I.; and medical director, Physical Medicine and Rehabilitation Services at the QEH