Thomas Byrne (Meath East, Fianna Fail)
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The Minister for Health, Deputy Donnelly, would like to thank Senator Gallagher for facilitating this chance to update the House on this important matter. The Minister is in the Dáil this morning answering health questions, so that is why he is not here.

Enhanced community response is critical to improving cardiac arrest survival rates, and this is wholly recognised in the national out-of-hospital cardiac arrest strategy, OHCA, from 2019, which is called Putting Survival at the Heart of the Community, from 2019. The National Ambulance Service, for example, has a network of more than 250 community first responder schemes supported by a community engagement team. In the event of a cardiac arrest, automated text messages direct community first responders to the scene of a cardiac arrest that occurs in the catchment area. The role is to help stabilise the patient by providing CPR and defibrillation while awaiting an ambulance crew. The evidence clarifies the significance of this role, as this time from collapse intervention is a direct determinant of cardiac arrest survival.

The strategy clearly sets out that improving survival from out-of-hospital cardiac arrest involves a number of initiatives. In 2021, percentage survival from out-of-hospital cardiac arrest was reported as 6.1%, with 178 people returning home to their families. One important aim of the out-of-hospital cardiac arrest strategy is to support Ireland to achieve similar survival rates to the best-performing European countries who, more consistently, achieve rates exceeding 10%.

Implementation of the national out-of-hospital cardiac arrest strategy is managed by the National Ambulance Service, with a multi-agency governance group drawn from the HSE, the national directorate for fire and emergency management, An Garda Síochána, the Pre-Hospital Emergency Care Council, the Irish Heart Foundation, Community First Responders Ireland, Dublin Fire Brigade and the Red Cross, as well as national and international academic expertise.

In countries that have achieved improved out-of-hospital cardiac arrest survival rates, police and the fire service are routinely dispatched in tandem with ambulance services. In line with this, the out-of-hospital cardiac arrest strategy recommends opportunities to involve An Garda Síochána and the fire services. The strategy and recommendations are endorsed by Government and are currently being developed and implemented.

Firefighters and gardaí from a small number of retained fire stations and Garda units, and Senator Gallagher has mentioned some of them, currently provide a response to cardiac arrest in their communities. Support for this is provided by the National Ambulance Service community engagement team, which manages and co-ordinates the community responses. Support includes provision of information sessions to firefighters and gardaí who are interested in providing an out-of-hospital cardiac arrest response, training days and follow-up meetings to participating services. Instructor training is also provided to enable each participating service to train its members to the appropriate responder level. Individualised post-call follow-up for difficult situations is also provided.

In common with other responders in the community, An Garda Síochána members and fire services personnel are provided with clinical governance through the National Ambulance Service clinical director, with co-ordination through the National Ambulance Service community engagement team. The out-of-hospital cardiac arrest strategy does not include a specific recommendation to equip gardaí, emergency services and fire service vehicles with automated external defibrillators, AEDs. The focus is on building the capacity, through teams, to respond quickly in the community.

Thomas Byrne (Meath East, Fianna Fail)
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I thank Senator Gallagher. The Government is committed to ensuring Ireland continues to improve out-of-hospital cardiac arrest survival rates through supporting the strategy and all the work towards achieving a target of greater than 10% survival, as the Senator just said. To do this, there is a commitment to work with the National Ambulance Service in pursuing and endorsing opportunities to involve An Garda Síochána and the fire services. The strategy governance implementation group will continue its work to strengthen further the involvement of retained fire services in community first response to cardiac arrest.

Improving survival from an out-of-hospital cardiac arrest involves a number of initiatives. One of these is a specific aim to implement a National Ambulance Service national AED or defibrillator registry, which will be mapped on the National Ambulance Service dispatch system, and a supporting app for dispatching first responders. Work has already begun on developing this registry.

It is a good opportunity for all of us thank all of our emergency services who are part of the public service: An Garda Síochána, the fire services, the National Ambulance Service, mountain rescue, coastal rescue, and all of these people who do fantastic work. We should also thank our volunteer community first responders as well. It is an initiative that has grown up in recent years, and it is tremendous to see the commitment right across the country from ordinary people who have effectively trained themselves up, with assistance from the National Ambulance Service, etc., to be available within their community as first responders to keep people alive. Our thanks goes to them.