Matter of opinion
By Jason Brooks
Are slow ambulance response times in Ottawa killing people?
Just 5.4 per cent of people in Ottawa survive out-of-hospital cardiac arrests. A new regional study ties this to tardy ambulance responses.
The low save rate of cardiac arrest victims is “not unexpected given the long ambulance response times,” says the report. In Ottawa, ambulances take almost 15 minutes to reach most emergency scenes. In West Carleton, they take longer than 30 minutes.
But faster ambulances won’t necessarily save more heart attack victims. Here’s why:
When people have a severe heart attack, their heart usually goes into a state of “ventricullar fibrillation” – where the heart just quivers.
The best way to get the heart beating again is with an electric shock – from a cardiac defibrillator. That’s the device you see on the television show ER, the scene where the doctor yells “Clear!” and bolts the patient with two electrically charged steel paddles.
A shock must come fast. After four minutes, brain damage sets in. Chances of survival drop 10 per cent each minute. Even in Toronto, where ambulances reach patients in a speedy nine minutes, it isn’t fast enough.
So what’s the solution?
In the late 1980s, defibrillators first appeared outside of hospitals in Ottawa. They were installed in ambulances. Not surprisingly, given the long response times, the results weren’t encouraging.
In 1993, the region installed the machines in fire trucks – which reach an emergency scene in 4.5 minutes, much faster than ambulances. The save rate for cardiac arrest victims more than doubled, from 2.5 per cent to the current 5.4 per cent.
The next step doesn’t require government. It needs private entrepreneurs.
Recent technological advances have produced civilian versions of cardiac defibrillators. They are easy to use, and can be installed in office buildings, health clubs and shopping malls.
A voice in the machine guides users through defibrillating patients, from sticking thin gel-covered pads to the victim’s chest to pressing a button to give the shock.
The machines, the size of a laptop computer, measure the victim’s heart rate and shock only when needed.
I visited the fire department, and learned the basics of how to use one in 15 minutes — although full training takes a day for someone already schooled in CPR.
Doctors say there’s little risk in properly trained civilians — lifeguards or security guards, for example — using the machines. Doctors I talked to at the Ottawa Heart Institute say they encourage it.
Many airlines have already installed them on airplanes. Casino Windsor has one, as do some Toronto office buildings. In Ottawa, the Dovercourt recreation centre recently installed one and Parliament Hill just bought two.
Setting up a defibrillator isn’t hard. Private companies and the Canadian Red Cross offer training courses and will arrange for a doctor to certify the user. Some machines — which cost about $4,000 — come with liability insurance.
Faster ambulance responses would be nice. But the best way to beat the number-one killer is for savvy entrepreneurs to take advantage of new business opportunity.
After all, as a customer, would you rather go to a health club, a concert, a hotel that has a defibrillator or one that doesn’t?