A national trial and a first for Scotland involving Scottish Fire and Rescue Service (SFRS) and Scottish Ambulance Service (SAS) to increase survival rate of patients who suffer out of hospital cardiac arrest goes live today (29 October 2015) in selected areas of Scotland.
The trial will run at seven stations in the West Lothian (Bathgate and Linlithgow), East Lothian (Musselburgh), Aberdeenshire (Turriff) and the Scottish Borders areas (Hawick, Lauder and Coldstream).
Firefighters at these stations have received enhanced training in life-support, through a joint partnership approach with the Scottish Ambulance Service as part of a range of measures that it has in place across the country to target the condition and create a nation of life savers.
The trials are part of SFRS’s commitment to supporting the Scottish Government’s Out of Hospital Cardiac Arrest Strategy, which aims to dramatically increase patients’ survival chances and save as many as 1,000 lives by 2020.
The Scottish Ambulance Service works with clinicians and trade union partners to develop new models of care for OHCA and delivers support for CPR training programmes in schools and communities, along with the introduction of public access defibrillators. There are now more than 100 Volunteer Community Responder schemes across Scotland who are trained and equipped to deliver early life saving care.
SFRS recently announced a pioneering partnership with the British Heart Foundation which saw CPR kits donated to all 356 of Scotland’s fire stations. These stations will serve as bases for members of the public to visit and learn life-saving skills using a self-teach DVD and manikin.
Each year, almost 3,500 people, of the two million patients who receive ambulance care in the country, undergo attempted resuscitation after suffering an out-of-hospital cardiac arrest. Fewer than one in 20 survive to be discharged from hospital – far below the one-third of patients in Scandinavia who survive to return home. However by targeting them with more ambulance crews and additional training, the Scottish Ambulance Service has recently achieved a 10% increase in the number of people suffering cardiac arrest being successfully resuscitated at scene.
SFRS Chief Officer Alasdair Hay described how firefighters could help save patients’ lives, saying: “Time is absolutely crucial to the chances of survival and we have been exploring with the Scottish Ambulance Service how we can support it in responding to out of hospital cardiac arrests.
“There are more than 350 fire stations across Scotland and many of these are in rural and remote communities where a paramedic could be a considerable distance away. Our retained and volunteer crews live and work within five to eight minutes of their stations, meaning they may be able to provide a faster response when emergencies arise.
“In urban areas where we have stations with 24-hour staffing these crews could be available to immediately respond at times when our ambulance colleagues are busy attending other calls. These trials build on the already strong partnerships between the fire and ambulance services and will lead to a better understanding of how we can help save lives in this area.”
Jim Ward, Medical Director, Scottish Ambulance Service, said: "The average ambulance response time to a potentially life threatening emergency in Scotland is 6.6 minutes and we know that in cardiac arrest cases early CPR and defibrillation can improve survival. This trial with the Scottish Fire and Rescue Service supports the Scottish Government’s strategy for improving survival from out of hospital cardiac arrest and aims to further increase early provision of CPR and defibrillation.
“If a fire service resource with a crew who are trained to provide high quality CPR and have a defibrillator is nearer to a potential cardiac arrest than a local Community First Responder team, then Ambulance Control will dispatch them at the same time as the ambulance crew, so that they can provide these life saving interventions while the ambulance is on it’s way.”
At the centre of the approach is the ‘Chain of Survival’ – a concept describing the factors known to be crucial to giving a person the best chance of life. It includes early recognition that a cardiac arrest is happening, early cardiopulmonary resuscitation (CPR) to buy time, early defibrillation to restart the heart and post-resuscitation intensive care to restore quality of life.
Firefighters participating in the trials will receive enhanced CPR training to better equip them to deliver life-saving treatment until ambulance crews can reach the scene. The initiative follows talks between SFRS and the Scottish Ambulance Service, the NHS, the Scottish Government and the Fire Brigades Union.
SFRS says it ultimately hopes to train every member of support staff in the use of CPR. The trials are about saving lives, improving patient outcomes and reducing inequality in society by providing a more equitable response to local communities through a collaborative approach using joint assets.
Chief Officer Hay added: “The Scottish Fire and Rescue Service is dedicated to protecting the public and we are tasked with working in partnership with others to improve the safety and wellbeing of people throughout Scotland. Close working between ourselves and our ambulance colleagues clearly benefits the public and we will always look for opportunities to develop it further.
“These trials are among a number of ways in which we are delivering on our commitment to supporting the Out-of-Hospital Cardiac Arrest strategy. We will also work with our ambulance colleagues to ensure the location of all our defibrillators is mapped on their database and that these are placed where evidence shows they will offer the greatest benefit.”
“When a patient leaves hospital after being successfully treated for cardiac arrest they receive a discharge or care plan, which includes assessments of their needs to ensure they can live safely in their homes. By working with the NHS and other partner agencies we can include fire safety within these assessments, directing our preventative activities like home fire safety visits.
“People who have medical conditions or difficulty in getting around can be at higher risk from fire in the home, so this joined-up approach will help save lives. It’s a clear example of how integrated services help protect the public and that will always be at the centre of everything we do.”