Our society is facing a significant opportunity. If we tackle the perceived barriers to action, which can certainly be overcome, we will be able to save countless lives.
In a blog post earlier in the year, I outlined my alarm at discovering the survival rate for out-of-hospital cardiac arrests. Fewer than one in 10 people survive after suffering one of these. There are around 30,000 deaths from out-of-hospital cardiac arrests in the UK each year. Worldwide, the figure is approximately 3,420,000 deaths annually – a staggering number. All of this is even more shocking given there are steps that we, as a society, could take to prevent such loss of life. Surely, we can do better.
If a cardiac arrest victim is defibrillated within three to five minutes then the survival rate is transformed, reaching as high as 70%. The problem? We do not have access to enough defibrillators.
In the UK, there has been a push to put defibrillators in public places. I believe we need to go even further. I have proposed that portable defibrillators are placed in vehicles – as many as possible – from new cars, to delivery vans, to taxis, to police cars. These vehicles, with defibrillators inside, have the potential to save numerous lives.
Over recent months, I have been in touch with vehicle manufacturers, supermarkets (with their delivery fleets in mind) and police constabularies. In their replies, the same themes surface time and again. Expense, storage issues and concerns over liability are just some of the perceived barriers to action. I believe, however, that these barriers are surmountable.
Ease of use
Gone are the days of unwieldy devices that can only be used by experts. Modern defibrillators are incredibly easy to use. No medical knowledge is needed; the machine does all of the hard work for you. These high-tech devices will read a victim’s heart rhythm automatically, assess at what point a shock is necessary, and give you verbal instructions so you know exactly what to do.
Durability
Modern portable defibrillators have been designed for use in a wide variety of conditions. From construction sites, to railway maintenance sites, to swimming pools, the devices used in these contexts need to be hard-wearing.
The ‘IP Rating’ scale is used to help indicate the ‘ruggedness’ of an electrical device. This relates, usually, to the protection of electrical components against objects in the environment and to levels of water-resistance. Defibrillators that score highly on this scale are, for example, protected against dust and can survive low-pressure water jets being sprayed at them from any direction. Then there is the level of pressure that some of these devices can withstand. Some defibrillators are designed to withstand loads of up to 1000lbs, making them ‘crush resistant’.
While not all defibrillators are built to such specifications, even those with lower scores are still designed to be robust. When used in a standard vehicle, durability need not be a cause for concern.
Storage
There are a number of potential storage issues, which I will tackle in turn:
– Temperature: Modern defibrillators, with their specialist components, become compromised if they experience temperatures below or above their specified range. The standard range is 00C to 500C, with some variation depending on the make and model. The devices favoured by the National Ambulance fleet in Abu Dhabi, for example, have been designed for use in temperatures of up to 550C. While such extreme heat is not a concern in the UK, cold weather can be an issue. When temperatures are set to fall below 00C, an insulated storage case can help; some even come with their own heating element. Meanwhile, when a vehicle is not in use the most obvious solution – at the end of your shift or when you arrive home – is to take your defibrillator inside.
– Security: For defibrillators in public places, there are a number of reasons to keep devices in a secure location. These include to protect against theft, vandalism and the weather. Concerns such as these fade into the background, however, when defibrillators are kept in vehicles that themselves can be locked and alarmed.
– Weight: The weight of devices has been raised by some as a concern, particularly in relation to emergency vehicles. However, modern portable defibrillators start at around just 1.5kg. This is equivalent to the weight of a standard laptop or a couple of medium-sized bottles of water.
Maintenance
Regular maintenance is, of course, important. This includes checking a defibrillator for any warning signals (either on the digital display or via audible sounds), checking the expiry date on the electrode pads, checking the battery, and checking for signs of damage. If your device is registered on The Circuit – the national defibrillator network – then you will receive regular reminders to record checks. All of this activity can be easily completed alongside other routine, vehicle checks.
Liability
In today’s compensation culture, some have concerns around liability. If a driver stops to help a cardiac arrest victim using a portable defibrillator but the victim sadly does not survive, what is the liability for the driver – or their employer, if it is a work vehicle?
In the UK, to help in situations such as this, we have the Social Action, Responsibility and Heroism Act (SARAH act). This means that if someone intervenes to help in an emergency, their actions do more harm than good and a legal case is brought against them, the courts will take into account the context of that person’s actions. Resuscitation Council UK points out, however, that with out-of-hospital cardiac arrests it is ‘virtually impossible’ to leave a victim in a worse position than they would have been without any intervention.
Cost
Cost is, often, what decisions such as this come down to in the end. For a police unit or car manufacturer or delivery company to embrace portable defibrillators in their vehicles, they need to be able to afford it.
Currently, the price of an individual unit is more expensive than many can budget for. However, it takes just one enterprising individual to strike a deal where these defibrillators are produced in bulk and the price would plummet.
In reality, if a private business – such as a car manufacturer – agrees to place defibrillators in its cars, this will involve some level of expense. The decision, however, must go beyond the bottom line. This is about spending money for the good of the community. It is corporate social responsibility in action. It is the act of an upstanding, innovative company. The return-on-investment is your reputation.
Ultimately, none of the concerns outlined above need be reasons to avoid placing lifesaving devices in our vehicles. It only takes a handful of influential people – innovators, pioneers – to set the wheels in motion… Others will then follow. Their actions will save lives.
Jonathan Harris