By Liam Sagi, AACE national strategic lead for out-of-hospital cardiac arrest
Last week saw the annual #RestartAHeartDay across the world with hundreds of organisations coming together to teach CPR and defibrillator use to thousands of people. It was fantastic to see the incredible effort across the sector and from our partners in delivering this vital training to the public.
With this in mind it seems like an opportune moment for reflection on the work AACE have been undertaking alongside NHS Charities Together and ambulance trusts. This work has been focused on reducing inequalities in out-of-hospital cardiac arrest (OHCA) and ultimately aiming to improve outcomes for patients as well as experiences for bystanders and staff.
Our report in April
provided the foundations for our work and since publication we have been working to gain deeper understanding into the priorities for focus. It goes without saying that delivering change across the chain of survival is not without its challenges, yet we continue to see passion and dedication to the cause, so thank you all for your continued investment.
Turning the tide on OHCA cannot be done in isolation or without collaboration with our external stakeholders.
To that end, in the last few months we have brought together external stakeholders and ambulance services in two roundtable events centred on determining the priorities for us all and identifying areas for funding and partnerships.
This work has provided vital insight as well providing opportunity for showcasing current projects and initiatives. In turn this has helped to guide and support ambulance services, together with their charities, to consider where funding as part of the NHS Charities Community Grand Fund can deliver the most impact.
It was clear from the roundtable discussions that collaboration and partnership is key to success and as a result of these conversations, AACE were delighted to support North East, Yorkshire and West Midlands ambulance services to partner with the British Islamic Medical Association (BIMA) to support their annual Lifesavers project. Such collaborations strengthen our community relationships and develop our understanding whilst also delivering life saving skills.
We know that training communities where the first language is not English is important in reducing inequalities in OHCA. Several ambulance trusts have recently completed work to produce resources in languages representative of their community. As part of the AACE work we are working to collate these resources into a single point of access for the sector to reduce duplication of work in a time and resource limited service.
Improving the quality of bystander CPR prior to arrival of ambulance services is an under-explored area, at least in the UK. As such, East of England Ambulance Service is seeking to undertake a trial of video-assisted CPR as part of a dedicated OHCA desk within their Ambulance Operations Centre. As this project evolves, we will share more details across the sector for learning.
Defibrillator registration is increasingly rapidly towards the 100k mark which is an incredible achievement. The next important step is to ensure that as ambulance services, we are deploying these in the most effective way and ensuring as many defibrillators as possible are ‘rescue ready’. We have supported, and are pleased to see adoption by ambulance services, of the unlocked defibrillator consensus statement recently published by the Resuscitation Council UK.
While increasing numbers of available defibrillators is important, we now need to direct efforts on optimal placement of these new defibrillators to reduce inequalities. Evidence demonstrates that areas of deprivation and low bystander CPR have less access to public defibrillators.
Volunteers play an integral role in OHCA whether this is our Community First Responders, GoodSAM responders or volunteers involved with community engagement and training. We continue to support trusts to ensure we are deploying volunteers in the most effective ways, but work is also ongoing to ensure our volunteers are representative of the communities we serve.
Joe Crook (AACE National Volunteering Lead) and the Volunteer Strategy Oversight Group are leading work to explore innovation in this space such as scaling up the Positive Action project from NEAS, which engages with local ethnic minority communities to recruit, train and deploy community ambassadors.
We know that tackling health inequalities relies on high quality data to support identification of underserved populations as well as evaluating the work we have done. We are therefore working with our partners including NHS England to unlock some of this existing health inequality data. Access to training, and even the ambulance service, is also compounded by inequalities and ongoing research studies will hopefully provide important intelligence to tailor our approach to this.
Finally, research undertaken by St John Ambulance this month has demonstrated that women are less likely to receive bystander CPR, further highlighting the breadth of inequalities that exist in OHCA.
As a result they have launched a campaign to raise awareness through the CPR Bra.
This campaign supports the work by Jenny Legg to break down barriers in using defibrillators on women in OHCA.
Further information can be found in the ALF 2024 OHCA video here:
