19 Jul 2011
By Grace Chua
Devices at key locations can help lower heart attack deaths
PUTTING machines that jump-start patients' hearts in 10 key locations around the island could save the lives of more than 30 cardiac-arrest victims every year, according to a senior emergency medicine consultant.
Professor Marcus Ong of the Singapore General Hospital carried out research into the best places to install the devices, called automated external defibrillators or AEDs.
They include Changi Airport, the Subordinate Courts and tourist hot spots such as Sentosa and the Night Safari.
Prof Ong believes the devices can save lives only if they are accessible to the public, saying: "It's not enough just to have (them) if they're locked away in a security office somewhere."
More people should be trained to use the machines, he added. This is because bystanders are present in more than half of cardiac-arrest cases. With the proper training, they could mean the difference between life and death.
Every year, more than 1,000 cardiac arrests happen in Singapore. Only 2.7 per cent of victims survive – compared to nearly 20 per cent in the United States, Europe and Japan.
To help save lives, at least 280 AEDs are already installed across the island, according to a voluntary registry kept by the Singapore Heart Foundation. They tend to be located in places such as sports centres and cinemas. The defibrillators cost between $2,500 and $3,000 each, which means placing them everywhere is not practical.
Prof Ong scoured the cardiac-arrest statistics from 2001 to 2004 to find the locations where they most occur. At all of the 10 places he identified, at least one person had suffered a cardiac arrest – which means the heart stops beating properly – in five years. This threshold is based on guidelines by the American Heart Association.
Although more than 70 per cent of cardiac arrests in Singapore happen at home, Prof Ong explained it would not be practical to have a defibrillator in every household.
It does make sense, however, to put them in high-risk areas, such as those where a lot of elderly people live. For example, Toa Payoh's Kim Keat precinct last year became the first to have a defibrillator installed. Some residents were trained to use it.
Some of the locations Prof Ong highlighted already have the devices, or are planning to install them, a check by The Straits Times found.
All Singapore Civil Defence Force ambulances have them. And last month, Changi Airport Group called a tender to supply the life-saving gadgets at its four terminals. The deadline for bids has been extended "due to requests by multiple interested suppliers", said a note on government procurement website GeBIZ.
Sentosa, Suntec International Convention and Exhibition Centre, and the integrated resorts also have publicly accessible defibrillators.
Yet buildings are not legally required to have the machines, and there are no guidelines on where to put them. Asked if there should be a legal requirement, Professor V. Anantharaman, chair of the National Resuscitation Council, said that education and awareness were the most important things.
"Whether we have a law or not, what is more important is that people be educated about cardio-
pulmonary resuscitation (CPR) and the proper use of AEDs, and that combining CPR and AEDs can help more people to survive."
In January, then Health Minister Khaw Boon Wan announced a target of training one million people in CPR by 2020.
Over the past few years, the demand for CPR training has gone up. Last year, it rose by a quarter, said the Singapore Heart Foundation.
Prof Ong plans to present his research at an emergency medicine conference in Greece in September. "(Surviving cardiac arrest) should not be luck," he said. "There should actually be a system in place. Such things occur in predictable patterns, so you can identify these places, and put in place solutions."
caiwj@sph.com.sg
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