Automated External Defibrillators: Public Access

Stuart C McDonald Excerpts

Thursday 18th November 2021 Westminster Hall

[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

Thank you, Mr Hollobone. I am very honoured to be a replacement for Mr Thomson— I do not know how able, but I will do my best.

I am very grateful to have the opportunity to contribute to this vital debate. I too pay tribute to the hon. Member for Strangford (Jim Shannon), who has been championing this cause for a considerable time and therefore is an expert on it, as he showed with his opening speech. I confess that, in contrast, I am comparatively new to the issue. Like many others, I had my interest in it sparked by the lifesaving treatment of Christian Eriksen at this summer’s Euros, to which the hon. Member referred, and by subsequent conversations with constituents. I have been able to start some productive local conversations with the two local authorities that serve my constituents and with the British Heart Foundation. I am keen to learn more, and already have learned quite a lot more in the course of the debate.

In launching a small local campaign to help raise awareness of cardiac arrest and how to respond, and to try to increase access to lifesaving CPR training and defibrillators, we opted to call it “Every Second Counts”. That is not remotely original, but it reflects the fact that, as hon. Members have noted, when it comes to surviving a cardiac arrest, every moment really does matter.

The numbers are stark when it comes to survival rates for the 30,000 out-of-hospital cardiac arrests that people suffer each year in the UK—just one in 10, as we have heard. However, if we think about that from a different perspective, it means that we have the opportunity here to save hundreds—thousands—of lives if we get the response right. The basic components of a successful strategy seem uncontroversial, as we have already heard. We need to ensure that people can recognise what a cardiac arrest looks like so that they can take appropriate action. We need to ensure that they know to call 999 and can perform CPR. We also need them to use a defibrillator if one is available.

Access to defibrillators is a vital component of the chain of survival. How do we improve accessibility, because currently, as we have heard, only a small percentage of out-of-hospital cardiac arrests receive bystander defibrillation? It is important that there is a greater understanding of when and how to use defibrillators. We must get across the message that they are easy to use so that people do not hesitate for fear of doing it wrong. I look forward to taking part in the training that the hon. Member for Strangford is going to put on for us.

We need to get defibrillators across the country registered on The Circuit so that when we call 999 we can be directed to the nearest accessible defibrillator. We all know that early defibrillation can massively increase someone’s chances of surviving an out-of-hospital cardiac arrest, but many defibrillators are never used because the emergency services simply do not know about them. The Circuit, an initiative by the British Heart Foundation, could prove an important step forward, and we all have a role in raising awareness in our constituencies.

A lot of good work is being done across the UK. We have heard about that already today. We all need to learn from each other, but we can also learn from good practice and what works by looking at examples from abroad. Denmark seems to be a model of good practice, which seems appropriate given what happened to Christian Eriksen. A training programme, the placement of 17,000 AEDs in the community and the implementation of a registry of where they are has seen impressive results. Survival rates have tripled largely because the rates of bystander CPR have shot up from 19% to 65%.

The Danes also use a smartphone Heartrunner app to alert responders trained in CPR and the use of defibrillators to any nearby cardiac arrest and the nearest publicly accessible defibrillator. Some 16,000 citizens joined that system in its first two months.

Sweden has seen survival rates double in the last 20 years, partly through mass CPR training—something we have heard about today—and SMS Lifesavers, which seems to be along the same lines as the Danish Heartrunner model.

It is not just about the number of accessible defibrillators, but where they are. It is brilliant to have two installed by voluntary organisations in the same street, but ideally we need to be able to target them where they are most needed, and we need to map that out. Some 80% of out-of-hospital cardiac arrests occur at home, so how do we get as many into areas of concentrated housing as possible? Some public buildings will be ideal for that, with many schools situated in the heart of communities, for example, but other large housing estates might not have such buildings, so how do we deal with that? On the other hand—the hon. Member for Strangford touched on this earlier—our more remote areas have low concentrations of people, but possibly longer to wait for an ambulance, so defibrillators could be all the more vital.

Again looking to Denmark and Sweden as an example, I understand that 200,000 people have access to emergency medical deliveries of defibrillators by drone. Studies in Canada have suggested that that could be a lifesaving option for rural areas. But perhaps we should learn to run before we try to fly. NHS Grampian has had some success in reducing response times to remote areas with teams of trained volunteer responders equipped with AEDs and vehicle locator systems.

On another related issue, I was concerned to read that those in the most deprived areas of the country are almost 20% less likely to receive bystander CPR, so we need to try to understand why that is and how we can address that problem. We need to address these issues to ensure the best response, and we would be wise to look at the type of work that has been undertaken by the resuscitation research group at the University of Edinburgh. I look forward to working with colleagues across the House to make sure that every second counts, and that we do everything we can to save lives.

I thank the hon. Members who supported this debate and express my support for their call to action.