EULALEE THOMPSON
IT MUST BE a well-kept secret that heart disease is this country's number one killer, accounting for about 30 per cent of deaths each year. (The average person in the street would perhaps identify violence as the number one killer.
Anyway, knowing of the number one killer, I was interested to attend the launch, on January 19, of the National Resuscitation Council of Jamaica (NRC) and to learn more about the 'chain of survival' - all the actions taken from the time a patient with heart problems collapses, to his or her transport to the hospital's emergency room, to his or her recovery.
Attending this launch, of course, raised many questions and only pointed to the gaping hole in actually activating the chain of survival here, which is the recommendation of the American Heart Foundation (so, why really was this NRC launched? Is it because of this Cricket World Cup 2007 thing? That was mentioned at the launch).
I have been trying, for example, to find out from the Health Ministry's Director of Emergency Disaster Management and Special Services, Dr. Marion Bullock-Ducasse, about calling this 119 number for ambulance service if someone collapses (most Jamaicans know that that number is tardily responded to, if responded to at all); then what of the availability of ambulances (do we in fact have working and adequate ambulances at our hospitals? I know that there are costly private ambulance services); then, are all ambulance personnel trained in cardiopulmonary resuscitation (CPR), first aid and to use the defibrillator (or the Automated External Defibrillator, AED) and furthermore, are there even AEDs available on ambulances and in all emergency rooms, and so on. All these issues are pertinent to the chain of survival.
I must acknowledge here that I am indebted to Gleaner columnist, Dr. Garth Taylor ('CPR and then what?' published February 7), for raising these questions in his article (he being a medical doctor), legitimising my own concerns as a journalist.
The NRC's main role is to regulate and standardise the training in CPR and first aid and also to regulate and standardise the operation of 'the chain of survival' (I imagine, when it is actually put in place). There are four links in this chain:
1. Early access to emergency medical services (identifying the person needing assistance, calling 119, rapid response and so on).
2. Early CPR (necessitating wider training in the community and among health personnel which the Heart Foundation of Jamaica has been doing).
3. Early defibrillation (as Dr. Rattray pointed out in his article once you administer CPR you then want to follow that action with defibrillation and the AEDs are the user-friendly version of the machine which anyone can be trained to use. Next time you go to an international airport just look around on the walls and you will see these little machines (the AEDs) that can administer a shock to the heart all around. You might even see them in some shopping malls overseas, just in case someone collapses in a public place.These countries, apparently take their number one killer very seriously.).
4. Early advanced cardiovascular care ( this include advanced airway management, medication and so on usually provided by trained paramedics as the victim is prepared to be transported to a hospital emergency room).
Seems like the only link in that chain that is nearly working is number two, CPR, and, of course, not enough people in Jamaica can do CPR.
Deborah Chen, executive director, Heart Foundation of Jamaica (the administrators of the NRC), acknowledged that there were several weak links in the chain but said that the policy issues had to be addressed by the Ministry of Health (i.e. Dr. Bullock-Ducasse).
"One of the links in the chain of survival is to make sure that people are properly trained in CPR ... We felt that we couldn't just throw our hands up in the air, and do nothing about it, we felt that we had to start somewhere, and one of the first things is the training ... (people) need to be transported to hospital and they need an ambulance and I agree with you that those links need to be strengthened," she said.
Please send your comments to eulalee.thompson@gleanerjm.com.
