Out of Hospital Cardiac Arrest (OHCA) Report 2014/15

MEDIA RELEASE 1 DECEMBER, 2015

St John Releases Out of Hospital Cardiac Arrest (OHCA) Report 2014/15

St John’s latest OHCA report reveals the emergency ambulance service has maintained a strong 15% survival rate for patients who are treated for cardiac arrest.

Numbers to survive a cardiac arrest are universally low. Of the 38 people who are treated for cardiac arrest by St John each week, 12 are successfully resuscitated and transported to hospital and 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 benchmarks itself against a number of ambulance services including Ambulance Victoria in Australia and London Ambulance Service in the United Kingdom, both of which have 10% survival rates.

“This is good news for New Zealanders and reflects on the skills of our ambulance officers and the quality of their care,” says St John Medical Director 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 impacting the cardiac survival system.

“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 emergency ambulance service and hospital personnel,” says Dr Smith.

“St John is working to improve patient outcomes by focusing on factors that affect this system or ‘chain of survival’.”

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.

New Zealand’s low rate of public access to defibrillators remains an issue. St John’s key partner ASB has installed AEDs throughout their branches nationwide but the OHCA report shows more are needed.

While 64% of patients had bystander CPR performed, only 4% of patients were defibrillated using a public access defibrillator.

The data in this report will drive important clinical improvements and processes. OHCA data has identified that Māori are more at risk than non- Māori and as a result St John has developed the ‘Marae Out of Hospital Cardiac Arrest programme’. St John Pou Takawaenga (Māori liaison officers) will work with Māori communities and maraes around NZ supporting training and access to defibrillators and CPR from early next year (2016).

Demographic Findings

• The most common cause of cardiac arrest was heart disease (77%)

• 64% of cardiac arrests occur at home and 19% happen in public

• Of the OHCA cardiac arrests attended by St John, 67% of patients were male and 33% female - the overall incident rate for males is more than double

• The average age of males was 63 years, females was 67 years

• OHCA in children is rare – 2% of incidents were children less than 16 years and the leading cause (33%) was Sudden Unexpected Death in Infants (SUDI)

• Māori were disproportionally affected with a higher incidence of cardiac arrest (122.4) compared with all other ethnic groups (less than 90) per 100,000 years

• Applying CPR and rapid defibrillation can increase a patient’s chances of survival by up to 40%

The OHCA report is available on the St John website (News & Info>Our Performance>Cardiac Arrest Report)

St John has developed free on line videos and a smart phone application for the public to learn how to do CPR and defibrillation:

- 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)

-ENDS-

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.

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