Fewer New Zealanders are surviving cardiac arrests that occur outside of hospital, with survival rates down for the second consecutive year – a fact experts believe is linked to disruptions caused by the Covid-19 pandemic.
St John Ambulance’s latest out-of-hospital cardiac arrest reports cover all cardiac arrests in the community attended by St John and Wellington Free Ambulance between July 1, 2020 and June 30, 2021.
During this period, more than 2000 Kiwis were treated for cardiac arrest in the community – about five per day.
Only 25% lived long enough to get to hospital, and 11% survived 30 days after being discharged.
This was down from about 27% resuscitated and transported to hospital, and 14% who lived 30 days post-discharge in 2018/19.
In 2019/20, 25% lived to arrive at hospital and 13% survived to day 30.
Heart attack and cardiac arrest are different: Heart attack occurs when an artery becomes blocked, preventing blood flow to part of the heart. People remain conscious and breathing.
Cardiac arrest occurs when the heart stops pumping blood – breathing stops, and the person loses consciousness.
A person’s chances of survival drops 10-15% for every minute cardiac arrest goes by without CPR or defibrillation (using an AED) – rates that dramatically improve the sooner CPR begins. Survival rates can more than double with community help.
In urban communities, the median time it took an ambulance to get to a patient was eight minutes. This increased to 12 minutes in rural/remote communities.
St John clinical director Dr Tony Smith said cardiac arrest from ischaemic heart disease remained one of the main causes of death in New Zealand.
The ongoing impact of the Covid-19 pandemic and lockdowns caused “a lot of disruption” to how healthcare was delivered, Smith said.
Hospitals, general practice and ambulance services were having to adapt and adjust “very quickly to an evolving situation”.
“We suspect some of this may have contributed to the slight drop in survival from cardiac arrest in the community,” he said.
This was echoed by Wellington Free Ambulance medical director Dr Andy Swain, who said data confirmed the pandemic contributed to the decline in survival rates.
In 2020/21, 68% of people treated for out-of-hospital cardiac arrest were men. Overall, 75% of patients received bystander CPR.
The median age for men was 66, and 70 for women. Three per cent of out-of-hospital cardiac arrests occured in children (13 per 100,000 people) – 60% were boys, with a median age of six months, and the remaining 40% were girls, with a median age of 12 months.
Māori and Pasifika people were more likely to go into cardiac arrest, and were less likely to survive.
Both St John and Wellington Free Ambulance provide CPR and AED awareness programmes free of charge to the public.
Both said they wanted everyone to know the 3 Steps for Life – calling 111 for an ambulance, starting CPR, and using an AED.