East Anglian Air Ambulance (EAAA) welcomes recent discussions on the treatment of cardiac arrest patients, published in the British Medical Journal this week. The article supports the need for immediate, good quality, cardiopulmonary resuscitation (CPR) and advanced medical intervention at the scene, in order to give the best possible chance of survival after a cardiac arrest.  This is exactly the treatment EAAA medics give to the people of East Anglia.

Jonathan Benger, Professor of Emergency Care at the University of the West of England, and Consultant at University Hospitals Bristol NHS Foundation Trust, argues that patients in cardiac arrest are best treated by highly trained ambulance staff, whom he believes, ‘must be empowered to use their skills to optimise CPR, achieve early defibrillation, and deliver the best possible care at the scene, with no thought of transport until spontaneous circulation has returned’. Professor Benger also warns that taking such patients to hospital before they have been stabilized may be actively harmful.

Consultant Anaesthetist and EAAA doctor, Jeremy Mauger, agrees: ‘When a patient has been resuscitated following a cardiac arrest, they may be very unstable and require high levels of critical care. Attempting to perform CPR in a moving vehicle is extremely difficult and can detract from delivering consistent and high-quality treatment. It is therefore vital that patients are given advanced life-saving treatment at the scene’.

Cardiac arrest outside of hospital is a common medical emergency experienced by about 60,000 people a year in the UK. Fewer than 10% survive to discharge from hospital. EAAA attended 289 cardiac arrest patients form January to August 2014, making up about a quarter of missions attended.

EAAA clinicians are able to work with ambulance crews to offer advanced CPR and defibrillation at the scene. They can also give other life-saving treatment by administering drugs, such as those that can keep blood pressure up and help to stabilize the heart rate. They also have access to advanced equipment, like automated compression devices, sophisticated ventilators and infusion pumps. As the EAAA medical team includes a doctor, they can intubate patients at the scene and therefore, take over a patient’s breathing; a procedure which may require an anaesthetic or sedation.

Dr Mauger explains: ‘Out of hospital cardiac arrest outcomes are improving in countries that encourage members of the public to do early CPR and we should encourage this. I would really like to see CPR taught in all schools as part of the national curriculum.  Sustained and good quality CPR plus early defibrillation make a real difference to cardiac arrest patients. Once compressions have been established, EAAA medics can work together with land ambulance crews to use their advanced equipment and training to give the patient the best chance of survival’