Is anyone here a doctor? The folly of relying on others to step in.

Is anyone here a doctor?  The folly of relying on others to step in.

You know the old trope: someone collapses in public, someone else calls out “is anyone here a doctor?” and a calm, attractive MD steps out from the crowd and takes control.

In most cases, the fact that this is a cliché would suggest it’s a common occurrence.  When it comes to people who experience a sudden cardiac arrest in public – often referred to as an out-of-hospital cardiac arrest (OHCA) – the opposite is true.

It is estimated that sudden cardiac arrest kills more than 6 million people worldwide, and has a survival rate as low as one per cent.  In the United States, sudden cardiac arrest claims more lives than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, road traffic accidents, firearms and house fires combined.

That would suggest there aren’t too many doctors walking around, in anticipation of a cry for help.

What this absolutely tells us, is that surviving an OHCA comes down to the willingness of bystanders to step in and help – specifically, call emergency medical services (EMS), perform CPR and wherever possible, apply defibrillation.

This is backed up by countless medical studies showing the correlation between early intervention and survivability of OHCA.

For example, a study by the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network found that people who were most likely to survive an OHCA had received CPR and out-of-hospital defibrillation in the minutes between their event and the arrival of emergency services.

These conclusions were drawn from analysis of more than 56,000 OHCA cases across seven countries – and they’re supported by many other similar studies.  One such example is this study enabled by Danish foundation TrygFonden, which showed an average overall survival of 40 per cent for OHCA patients who received defibrillation within the first few minutes of their event.

These two studies both discuss the importance of early intervention for OHCA patients, before emergency services arrive.  The PAROS study factored in an eight-minute ambulance response time, based on accepted international best practices – and found this window of opportunity to be insufficient in OHCA cases where early CPR and defibrillation had not been applied.

The single common recommendation of these and many other similar studies, is that OHCA patients need bystanders to step in.

This means that instead of crying out to see if there’s a doctor in the house, we need to call emergency services – and be ready to apply CPR and defibrillation ourselves in those critical minutes before an ambulance arrives.

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