Valentine’s Day 2020 saw the launch of Telephone – CPR (T-CPR) in Gibraltar. This initiative is the first of three, all of which aim to increase survival from out-of- ospital cardiac arrest (OOHCA). In this context, a cardiac arrest is when the heart stops beating suddenly and without warning, and it is estimated that this will happen to 20 people in Gibraltar this year. Without cardiopulmonary resuscitation (CPR), all these individuals will die. Because they are not in hospital, it is friends, work colleagues, relatives and strangers that are in a position to make a difference by starting CPR quickly and before the ambulance arrives.
Someone in cardiac arrest is unresponsive and not breathing. By performing chest compressions and mouth-to-mouth ventilation, blood containing oxygen is pushed around the body to the vital organs
in order to ‘buy time’ until the condition can be reversed. The brain suffers irreversible damage when deprived of oxygen and therefore, in order to secure the best outcome for a victim of sudden cardiac arrest (SCA), CPR must be started immediately and continued without interruption. Because of the rapid ambulance response times in Gibraltar, ‘chest compression only’ CPR may be sufficient, although chest compressions with mouth-to-mouth ventilation remains the gold standard.
From now on, anyone ringing 190 or 112 and requesting an emergency ambulance will be asked 4 questions to establish quickly whether the person is in cardiac arrest. Where this is the case, the caller
will be asked to commence chest compressions if they can. They will be given clear instructions and the 190 Controller will stay on the phone to help until the arrival of the Paramedic Ambulance.
The second phase willsee the expansion of the Public Access Defibrillation programme. The generosity of the public and commitment of the Cardiac Association has added 15 Automated External Defibrillators (AEDs) to the original 12 bought in 2012. A defibrillator delivers an electric shock to the heart to put it back into a normal rhythm. It can be used safely without training, provided the visual and verbal prompts are followed carefully. Not everyone in cardiac arrest will require defibrillation, but for those that do, the chance of survival is reduced by as much as 10% for every minute defibrillation is delayed. The 190 caller will be asked to send someone for an AED provided it is close by. AEDs are housed in green cabinets and are located in key positions around Gibraltar.
‘Kids Save Lives’ campaigns around the world have shown that where CPR training for school children is compulsory, survival from OOHCA is increased by as much as threefold. Furthermore, as children become aware that they can help, self-confidence and teamwork is improved. The Department of Education in Gibraltar hopes to roll out age appropriate CPR training at the beginning of the next academic year.
By increasing the chances of high quality bystander CPR and defibrillation being performed, T-CPR, the PAD programme and ‘Kids CPR’ will impact the lives of those people suffering an OOHCA positively. These initiativesform a partnership between the community and emergency services and should both significantly reduce the number of deaths from SCA and improve the quality of life experienced by the survivors. Give CPR and help us to help someone you love.
Tina Reyes-Hughes – Resuscitation Officer GHA
RN, LL.M (Dist)
Resuscitation Council (UK) Instructor
16th February 2020
Resources: https://www.resus.org.uk; https://www.bhf.org.uk; https://www.sja.org.uk
