Seanad debates
Tuesday, 22 June 2021
Nithe i dtosach suíonna - Commencement Matters
Defibrillators Provision
9:00 am
Mark Wall (Labour)
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I welcome the Minister of State to the House. We all looked in shock last Saturday week at the distressing scenes at the soccer match between Finland and Denmark when a young and fit international footballer dropped to the ground, suffering a cardiac arrest. The medical team on-site jumped into action and with the aid of an automated external defibrillator, AED, the player was stabilised and a life was saved.
Unfortunately, this is not the first time we have seen or heard of this happening on our playing pitches, whether it is in an international soccer stadium or local sports club grounds, or even in the many great communities we have on this island. The key to the survival of Mr. Christian Eriksen and so many before him was the availability of an AED and, just as important, the training of people in knowing how to use it. The Irish Red Cross estimates there are between 8,000 and 10,000 publicly accessible defibrillators in Ireland but the emergency services may only know approximately 25% of these locations. The key word is "estimates" and hence my reason for raising this on the Commencement today.
What we need in the country is a national central register of all available defibrillators and, like in other countries, an app to help in the speed and convenience in finding them. We must include and expand the terrific Community First Responders we have in this country. They are embedded in their communities and committed to saving lives. In my home town of Athy they respond to approximately one cardiac event each month and in our bigger towns, that number could be doubled or even trebled. These volunteers still have to fundraise by holding annual table quizzes, for example, to ensure there is continuous training for members. We need to fund this community organisation so it can provide training within their communities and so these community-based groups can ensure AEDs in their areas are working and particularly that batteries and pads are in working order.
As a public representative in south Kildare I hold fundraisers and been delighted to launch AEDs in every community there. However, it is vital that all these AEDs be registered and checked regularly to ensure they are in working order. There are examples of community groups using an app to register AEDs and this could be used on a national basis. One of those is the Enniscorthy defibrillator initiative, called PulsePoint, and it seeks to register all defibrillators in the town. Another is the work of Dr. Peter Naughton in County Laois mapping the location of all AEDs in the county so the emergency services could advise frantic callers in their hour of need of the nearest device. My colleague, Councillor Paul O'Brien in Wicklow, has proposed that a provision for AEDs should be included in all new major housing builds, which is an excellent idea and another way of providing safer communities in all our counties.
I have been made aware that in 2019, according to the out-of-hospital cardiac arrest register, there were 2,564 out-of-hospital cardiac arrests, or 54 per 100,000 of our population. The report also indicates that defibrillation was attempted in 25% of these cases before the arrival of the emergency services.
Of course, there is the great work done by the National Ambulance Service and its staff, who take those emergency calls in the first place, assisting even those not trained in the use of an AED. Where one is available, a call to the emergency services should always be made. We need investment in a national register and app by the HSE. We need investment in our Community First Responders to assist in their training and the training and assisting of people in clubs, shops and schools that hold an AED in the community. Such a register would save lives and ensure that a life-saving machine is working when it is needed most. It will continue to build support for a community-based initiative that is already making a difference and saving lives in the State.
Eugene Murphy (Fianna Fail)
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This is a very important matter.
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I welcome the opportunity to address this House on behalf of the Minister for Health, Deputy Stephen Donnelly, about the work under way in developing a national register for AEDs and to echo the comment on the good work already carried out by community first responder groups under the auspices of our National Ambulance Service.
As the Senator may be aware, the HSE is currently in the implementation phase of the out-of-hospital cardiac arrest strategy for Ireland. This strategy was developed by an interdisciplinary steering group, led by the Department of Health, which had the aim of increasing the number of people who survive an out-of-hospital cardiac arrest in Ireland, using national and international experience to address all the elements in the chain of survival.
The HSE has since established an out-of-hospital cardiac arrest strategy implementation group to progress this work. The group is led by the National Ambulance Service and actions are being progressed by partner organisations, including Dublin Fire Brigade, the pre-hospital emergency care council, the Irish Heart Foundation and An Garda Síochána.
In line with the Senator's question, one of the projects currently under way is a work stream to develop a national AED register. Currently, the National Ambulance Service has a list of locations for over 2,000 AEDs on its national computer-aided dispatch system, which it can use to advise emergency callers in AED retrieval and use, if appropriate, while the emergency response is en route.
Currently, the implementation group is examining how a national AED register would better support existing emergency response systems in an integrated way. This includes the development of advice and support that may be required in the community setting on maintenance requirements and other practical concerns, for example.
I am happy to confirm to the House that the out-of-hospital cardiac arrest implementation group has received funding of €650,000 in budget 2021 to progress this important work as part of the overall implementation of the strategy. In addition, it is important to again stress the services already provided at community level in the area of cardiac response, and the Senator has rightly cited the work carried out by the National Ambulance Service and Community First Responder groups in that regard. Community First Responders are trained volunteers who are co-ordinated and dispatched by the National Ambulance Service to attend actual or potentially life-threatening emergencies. As these volunteers are professionally trained in cardiopulmonary resuscitation and the use of defibrillators, they can respond to certain medical emergency calls in the community in that important first few minutes prior to the arrival of an emergency ambulance.
As highlighted by the Senator, our National Ambulance Service actively works with Community First Responders to advise and support on the importance of maintenance for their AEDs to ensure that they are operational at all times. The additional funding provided in 2021 in support of the work of the implementation group will facilitate progress on the AED register and other initiatives aimed at reducing cardiac arrest response times and improved survival rates for out-of-hospital cardiac arrest. I note what the Senator said about how these have been mapped in Wicklow, Enniscorthy and County Laois. I saw it after that the awful incident last week in Sligo. People were putting on Twitter and Facebook where AEDs were. It is the same in Boyle and I have seen it there. I am sure that is happening around the country. We cannot have enough of that information because when one is in an emergency it is great to have it. Even I have looked to find out the nearest one to me and I am sure that has happened in many households around the country. I thank the Senator for raising this.
Mark Wall (Labour)
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I thank the Minister of State for his positive reply. The sum of €650,000 allocated to the OHCA is a positive step forward in this regard. As the Minister of State said, there are a number of initiatives. I referred to one in Enniscorthy in Wexford, what happened in Laois and the initiative by my colleague, Councillor Paul O'Brien, in Wicklow. I ask the Minister of State to take those on board. Every minute makes a difference, and the Minister of State has acknowledged that. We must ensure there is a national register. These AEDs are located in schools, shops and sports clubs. However, as every minute makes a difference, when people and, most importantly, the National Ambulance Service receive a frantic call, they need to know where the AEDs are located. I welcome the fact that work is being carried out on formulating a national register. I ask that it be expedited given what has happened and the fact that people are talking about it at present. Now is the time to ensure that everybody knows where there is an AED, and I call on everybody to share that information as much as possible. I welcome the information given today.
Frank Feighan (Sligo-Leitrim, Fine Gael)
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I again thank Senator Wall for raising this timely issue. It has given me the chance to speak about the continued implementation of the out-of-hospital cardiac arrest strategy by the HSE, and some of the community services in place. It is my expectation that the funding provided by the Government in 2021 will result in real progress in the development of an AED register, and the HSE is already making progress on some of the practical elements that need to be considered in that regard.
In addition to this element of the strategy, I highlight the broader implementation work under way by the HSE and other agencies, as this will also support the dedicated work of the network of community first responders and the National Ambulance Service. Out-of-hospital cardiac arrest is a significant source of mortality and morbidity, with a wide variation in reported incidence and outcomes. Research shows that "it takes a whole system to save a life" and this is why a planned, strategic, whole-nation approach to improving OHCA survival is essential. On that basis, I am confident that the investment in the work of the OHCA strategy implementation group will achieve real and continued progress in survival rates for out-of-hospital cardiac arrest in Ireland.