Tuesday 23 June 2015

SGH launches simplified CPR programme for community, religious groups

The programme is part of the hospital's efforts to produce a CPR-ready community, after survey results show those who learnt simplified CPR gave better chest compressions than those who went through the standard training.
By Sara Grosse, Channel NewsAsia, 21 Jun 2015

You can still save a person's life even if you have not been taught how to do mouth-to-mouth resuscitation.

That is according to a recent study by the Singapore General Hospital (SGH) and the National Heart Centre Singapore on people who have learnt chest-compression skills versus those who have gone through standard cardiopulmonary resuscitation (CPR) training, which consists of chest compressions and mouth-to-mouth resuscitation.

SGH is now planning to expand the pool of people willing to respond to emergencies with an easy-to-learn CPR training programme, which also teaches participants to follow a medical expert's instructions in performing CPR and to use an automated external defibrillator. Called the Dispatcher Assisted first Responder (DARE), it is an hour long and specially designed by the Unit for Pre-hospital Emergency Care (UPEC) set up by the Ministry of Health.

A standard CPR training programme typically lasts four hours, and includes mouth-to-mouth resuscitation, but doctors said just having basic skills alone can still save a life.

"By focusing just on chest compressions, you can actually have good quality chest compressions, which is actually more important in the first few minutes of a resuscitation," said Associate Professor Marcus Ong, medical director at UPEC and senior consultant at SGH's Department of Emergency Medicine. "Ventilation, we still encourage everybody to learn, but in the first few minutes, it may not be that important."

However, there are some specific situations where ventilation is very important. For example, children in cardiac arrest or drowning. A recent study conducted from November 2013 to January 2014 of 85 participants backed this up. It found that those who learned chest-compression-only CPR gave better quality chest compressions than those who underwent standard training.

Quality of CPR performance was assessed two months after training and concluded it could be a promising alternative CPR method to be taught to the layman. Not having to learn ventilation could also encourage more people to take up CPR training.

Said a DARE participant, Mr Isaac Ho: "This is a step forward for people who are more averse to using the mouth to mouth process."

In Singapore, about 1,800 cardiac arrests occur every year. Only about three per cent of these patients survive the cardiac arrest compared to 20 per cent survival rates in Tokyo or Seoul. SGH hopes to increase this rate by training more people in CPR, such as grassroots leaders and religious groups.

A session at the Methodist Church of the Incarnation in Choa Chu Kang on Sunday (Jun 21) was the first collaboration between the Unit of Pre-hospital Emergency Care (UPEC) and the Inter-Racial and Religious Confidence Circle with religious and community groups in Singapore.

Over the next year, there are plans to roll out the DARE programme to the workplace, and conduct the training during lunch hours. So far, about five to 10 companies have been engaged. The government says everyone can do his part.

"Most out-of-hospital cardiac arrests happen in the victim's home or places he frequents, often in the presence of relatives, friends, or neighbours," said Health Minister Gan Kim Yong. "By preparing for the unexpected, the skills acquired today may end up saving lives of someone we know, someone we love."

DARE was first piloted in 2014 in schools, and has trained more than 8,000 people since.

The Dispatcher-Assisted First Responder training programme (DARE) is a simple yet important initiative which asks every...
Posted by Ministry of Health on Sunday, June 21, 2015

Thank you for the tremendous interest and response after our event yesterday. We do not have any public classes...
Posted by Dispatcher-Assisted first REsponder - DARE on Sunday, June 21, 2015

Timely use of CPR, AED can save lives

Mouth-to-mouth breathing is a recommended part of cardiopulmonary resuscitation (CPR) ("Need for a better way to administer CPR" by Mr Teo Kok Seah; June 7). When used together with an automated external defibrillator (AED), it provides the best chance to save the lives of those in cardiac arrest.

However, we do recognise that some members of the public may be hesitant when it comes to mouth-to-mouth contact with another person.

Most collapses (about 70 per cent) occur at home and witnesses are usually family members who would perform CPR on their loved ones more readily. Currently, mechanical ventilation devices are too bulky to be recommended for laypeople to carry around.

The National Resuscitation Council (NRC) and Singapore Heart Foundation (SHF) urge that any bystander unable to perform mouth-to-mouth breathing should at least carry out effective chest compressions till the arrival of an ambulance crew by the patient's side. If the bystander is unsure as to how to do CPR, call 995 and follow instructions on CPR given by the medical dispatcher until the ambulance crew arrives at the scene.

Over the past few years, various agencies have organised CPR and AED training for the public. Since 2011, the NRC's 80 accredited training centres have organised mass CPR + AED training sessions to teach the public these life-saving skills.

The Ministry of Health (MOH) and People's Association also set up a Community First Responder Programme in May last year to provide accredited CPR and AED certification courses free of charge to all Singaporeans and permanent residents at community centres.

This year, the SHF and MOH's Unit for Pre-Hospital Emergency Care jointly developed the dispatcher-assisted first responder (DARE) programme which was supported by the Singapore Civil Defence Force.

The programme includes a 45-minute video teaching the public about CPR and the operation of an AED, guided by a 995 medical dispatcher. Those who wish to find out more about the programme can contact the Dare team at dare_programme@sgh.com.sg

Modern public AEDs typically have battery lives of three to five years, and require little maintenance. We have taken note of Mr Teo's suggestion to have wired AEDs.

V. Anantharaman (Professor)
National Resuscitation Council, Singapore

Vernon Kang
Chief Executive Officer
Singapore Heart Foundation

Marcus Ong (Associate Professor)
Unit for Pre-Hospital Emergency Care
Ministry of Health

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