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Tom

Tom Noble

Year of Award: 2015 Award State: Victoria Health And Medicine > General
The Sir William Kilpatrick Churchill Fellowship to improve the awareness, availability and use of Automatic External Defibrillators - Netherlands, Denmark, UK, USA
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Outcomes

The highlights of my fellowship were insights into how different jurisdictions are attempting to identify and treat cardiac arrest patients with a defibrillator in the quickest time possible.

Studies show that if a patient can be defibrillated within three to five minutes of collapse, their chance of survival is 50-70 per cent; each minute of delay to defibrillation reduces the probability of survival to hospital discharge by 10-12 per cent.

AEDs are machines that can be placed in communities and used by anyone (the machine “talks”, giving step-by-step instructions) to shock a patient in cardiac arrest. Their numbers and use is increasing (usage up six-fold in Victoria in the 10 years to 2014-15) and there is significant potential to increase this usage further.

In Holland, the target is to defibrillate cardiac arrest patients within six minutes. While this target is not being met, it shows a clear intent. Holland also provides a great example of disruptive technology being used for good. The country has more than 100,000 volunteers trained in CPR and AED use who can be alerted to a cardiac arrest by an App on their smartphone. The responders are activated by the ambulance service and often reach the patient before the ambulance.

As one senior doctor noted, when paramedics began carrying defibrillators several decades ago, it was a new disruptive technology that saved lives. Today, with the correct infrastructure and a smartphone App, community members can respond in the same way as paramedics and use a defibrillator to save a life. These Apps are up and running in several countries, including parts of Holland, Sweden, Denmark, the UK and the US (as described in my report). Yet they are not an answer in themselves, as they require strong infrastructure, including an effective AED Registry, working links to computer aided dispatch, strong program governance, engaged volunteer responders, good community and stakeholder relationships, and appropriate media promotion.

It is clear that there is significant potential to engage and enable the community to save lives through this technology. My hope is that it will be up and running in Victoria some time in 2017.

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