Published on 15th November 2021
Using public transport whether it is for work needs or for leisure activities can sometimes feel like you’re putting your life into the laps of the gods. You’re not driving, you’re not in control of the vehicle, and you are clueless about who you’ll be sitting by.
This brings us onto our topic – Sudden Cardiac Arrest on public transport. If you happen to be sitting next to a cardiac doctor or nurse trained in CPR who might know exactly how to access a defibrillator within the first few minutes of your cardiac arrest, you may become one of the 6-10% of people who survive their (out of hospital) sudden cardiac arrest.
If you are not sitting next to them though, you’re unfortunately sitting in the other 90% of the statistics that don’t survive their SCA.
There is an AED on board. Access to an AED is critical in increasing the chances of survival for an individual experiencing a cardiac arrest. In fact, timely access to a defibrillator within the first few minutes of an arrest can significantly improve survival odds, increasing them from 10% to as high as 70%. And the good news is that many AEDs widely available now have been designed to be able to be used by a bypasser (or even a child) with no previous cardiac training.
The irony is that we started this article saying you could feel like you’re in the laps of the gods travelling by public transport, but if you’re travelling in a vehicle supplied by a company who has invested in defibrillators like many are now doing, your journey could actually be less risky than you travelling on your own by car for instance.
If you apply the sudden cardiac arrest survival statistics to the sheer number of passengers using public transport, it highlights the importance of first aid and health provisions being accessible in case of emergencies. Government statistics show that during 2019/2020:
With that level of usage and the success of campaigns over recent years, many transport providers are actively investing in defibrillators across their transport networks.
One surprising scheme which we’re really pleased to share is a partnership between The London Ambulance Service and the Licensed Taxi Driver’s Association. Their pilot scheme rolled out across 6 months, trained taxi drivers to be able to assist in a sudden cardiac arrest emergency and equipped them with defibrillators.
Thirty drivers were trained in CPR and fifteen black cabs were given a defibrillator. Each driver participating in the scheme also downloaded the GoodSam App which displays any emergency calls made by integrating with ambulance service systems. This combination meant that any taxi driver nearby who is part of the scheme can attempt to save a person by stepping in while an ambulance is en route.
Glasgow Taxis, the second-biggest taxi firm in Glasgow have also installed 15 defibrillators within their network. Alongside their partner, Defib Machines, they have pledged that if the initiative proves to be a success, they will roll out even more AEDs and in Moray, a taxi firm has become the first company to be equipped with defibrillators in Scotland. Even individual drivers are being proactive with their participation too with a Southside Cars taxi driver in Nottingham investing in a defibrillator for his cab using £1,000 of his own money.
Imagine what a difference this collaborative approach could make if it was rolled out on a much wider scale.
There isn’t an official requirement dictating that rail operators should install defibrillators, but many of these networks have been doing it by their own choice. Resuscitation Council, a healthcare charity focussed on CPR awareness shared that busy transport hubs will usually justify a cardiac arrest risk rating as being ‘moderate’ to ‘likely’.
With trains travelling through such remote and often inaccessible parts of the country, there is the additional risk that a sudden cardiac arrest may happen miles away from a station too, so the proactive momentum for providing defibrillators has been growing. Back in 2016, 50 Public Access Defibrillators were rolled out by Northern Rail across 13 of its 465 stations. ScotRail and Southern Rail also have defibrillators installed in some of their stations. Virgin’s philosophy has meant that passengers have been heart-safe since 2014 too, with defibrillators being installed on all of their 390 Pendolino trains which is a significant respect and investment in the life-saving ability of the AEDs.
Not every station has a defibrillator installed yet but Transport for London has been equipping multiple stations with defibrillators as well as Tyne and Wear rolling them out across their Metro Network too.
In 2017 and partnering with St John’s Ambulance, Edinburgh trams installed defibrillators on every one of the 27 trams in their fleet. The defibrillators were funded by local businesses, voluntary organisations and fundraising activities of individuals whose lives had been saved because of easy access to a defibrillator when they needed it.
10.4% of all out of hospital cardiac arrests reported in 2021 occured in public and the only definitive method of treatment is immediate CPR and use of a defibrillator. When someone has fallen victim to sudden cardiac arrest, every minute counts. If treatment is delivered within 3-5 minutes, their chance of survival can increase up to 70%. However, for every minute that treatment is delayed, their chance of survival decreases by 10%.
Whilst airlines are required to keep a first aid kit onboard their aeroplanes and to train cabin crew in first aid, they are not currently required to carry defibrillators. It is estimated that each year 1,000 people die on commercial flights from cardiac arrests.
This was brought to the public’s attention in 2017 when Natasha Ednan-Laperouse collapsed on a British Airways flight. A severe reaction caused by sesame seeds present in the Pret baguette she had eaten instigated a cardiac arrest. Whilst the issue arose from the allergic reaction, the court case highlighted that part of the issue was the standard of the first aid provision because a defibrillator was actually present on the plane but wasn’t used.
This demonstrates the need for training, but in the case of many AED devices, they are designed for bystanders to be able to successfully administer defibrillation so could have been used by a passenger had they known of its presence.
This is where the importance of having defibrillators is starting to be taken more seriously. A fleeting check has shown that airlines currently providing defibrillators for passengers include Air France, Aer Lingus, Air New Zealand, British Airways, Cathay Pacific, Easyjet, Emirates, Etihad, Finnair, Japan Airlines, Jet2, KLM, Lufthansa, Norwegian, Qatar, Ryanair, SAS, Singapore Airlines, Swiss Air, Thomas Cook, TUI, Virgin and Ryanair
The statistics surrounding how many airborne passengers suffer acute medical problems are vague due to how they are reported, with estimates varying between 1 in every 14,000 passengers and 1 in every 50,000 experiencing them. Cardiac arrests are thought to account for only 0.3% of all medical in-flight emergencies, but it is known to be responsible for 86% of medical in-flight deaths so it’s reassuring that so many airlines are now installing defibrillators on their planes.
Around 20% of SCA’s occur in a public place, including on public transport. SCA is now the largest killer in the world and this really doesn’t need to be the case. Through schemes such as the taxi companies and transport networks taking their role of keeping the billions of passengers they transport each year more heart-safe, this alone could make a significant dent in the SCA death rates in our country.
If you’d like more information on how you can buy or rent AED packages for your fleets, premises or settings to keep your personnel and customers safer, get in touch and our team will discuss the best options for your needs.