THERE HAVE been dramatic improvements in survival rates among Irish people who collapse from heart failure in community settings over the past few years, a conference in Dublin heard at the weekend.
A recent study in the emergency department at Dublin’s Mater hospital found that if patients who collapsed were found soon enough to potentially have their heart shocked back into normal rhythm by a defibrillator, then their likelihood of being discharged alive from the hospital increased almost fivefold from about 8 per cent to 39 per cent over the past six years.
Dr Joseph Galvin, consultant cardiologist at the hospital, said the improvement was down to a number of factors.
“That’s mainly due to the improvements in our ambulance services . . . they have now got defibrillators in every ambulance, which we didn’t have six years ago, and they have initiated full resuscitation, including the administration of drugs and intubation [putting tubes into the lungs to help the patient breath in the ambulance] by emergency medical technicians and paramedics who are now trained to a much higher level than they were six years ago.
“So this is now translating into a dramatic improvement in resuscitation rates and cardiac arrest survival rates.
“There have also been improvements in the community in terms of knowledge,” Dr Galvin added, “so now when somebody sees somebody unconscious on the street, they don’t assume that they’ve had too much to drink.
“I think that people are quicker to check these people, see if they have a pulse and phone 999 immediately.
“Even the ambulance dispatchers are now communicating with phone callers to instruct them on how to perform CPR while they’re waiting for an ambulance to arrive.
“All those things have contributed to these dramatic improvements,” he added.
Dr Galvin was speaking at a national conference on the prevention of sudden cardiac death on Saturday at UCD.
The conference was organised by the Irish Heart Foundation (IHF).
Meanwhile, Dr Brian Maurer, medical director of the IHF, said much of what could be implemented of the Sudden Cardiac Death Taskforce Report, published and adopted by the Government over two years ago, without incurring major additional costs had been done.
“For instance the reorganisation of the emergency services and so on has been proceeding,” Dr Maurer said.
“All ambulances now have defibrillators . . . and a very large number of individuals have been trained in cardiopulmonary resuscitation. So quite a lot has been achieved. “
However, he expressed disappointment that a number of the report’s recommendations, which he believed would save lives, had not been acted on.
“There are other areas where we’ve been very disappointed. For instance the HSE had agreed to the appointment of 11 co-ordinators for resuscitation throughout the country and a national co-ordinator and none of these posts have been filled.
“They’ve been lying there for two years. They’re absolutely vital to the strategy,” he said.
“None of them have been appointed and we were assured a year ago that they were a priority and that the funds were available for them.
“The second area that has been disappointing has been the failure to appoint a pathologist to provide the specialist pathology service which is absolutely crucial to the identification of people who may be at risk,” Dr Maurer added.
It is estimated that more than 5,000 people die of sudden cardiac death in Ireland each year. Of these, about 70 to 100 deaths are in the under-35 age group.