The chances of survival in the event of cardiac arrest are steadily increasing

When it's a matter of life or death, Beat Baumgartner can't use Rambos. "But people who have a big heart and can lend a hand," he says. Baumgartner is president of the "First Responders" in the canton of Bern. First responders are first aiders who are alerted in case of cardiac emergencies - and usually arrive on the scene before the rescue services.

There are 2700 first responders in the canton of Bern, in all the centres, but also in the nooks and crannies of the canton. "Good guys" they are, says Baumgartner. These trained laymen are a very cheap way to save lives, he says. "Where else do you find that in medicine?" The denser the network, the shorter the intervention time in an emergency. That's important. "Then every second counts."

This is what the world witnessed last Saturday. The Danish football player Christian Eriksen suddenly collapsed and lay motionless during the European Championship match against Finland. Immediately, his team-mates looked after him and called for help. Shortly afterwards, doctors and paramedics ran onto the field and began resuscitating Eriksen with cardiac massage and a defibrillator.

Eriksen suffered a cardiac arrest. The Danish team doctor later explained that the player had been unconscious. All of a sudden, he had no pulse. "We managed to bring Christian back." This quick and professional help was Eriksen's good fortune. He survived and now receives an implantable defibrillator (ICD), similar to a pacemaker.

Eriksen had suffered ventricular fibrillation - "the deadliest of all cardiac arrhythmias" - says Tobias Reichlin, deputy head of cardiology and head of rhythmology and cardiac electrophysiology at the Inselspital in Bern. This is a cardiac arrest due to "electrical chaos in the lower ventricle". In such a case, it depends on how quickly someone on the spot recognises what is going on.

Ventricular fibrillation is often the result of a heart attack caused by the blockage of a blood vessel. However, the often fatal cardiac arrhythmia can also occur in congenital heart diseases. "It often happens during physical exertion," says heart specialist Reichlin. But heart muscle inflammation - for example as a result of pneumonia - can also be causative. That's why it not only affects older people, but also young people, especially during sports.

In such a case, he said, one must immediately start chest compressions as cardiac massage. "This will move a minimal amount of blood." And supplies the brain with oxygen. This is important, otherwise a brain is damaged after three to four minutes and dead after ten minutes, he said. On the other hand, the ventricular fibrillation in the heart must be stopped. This requires an electric shock - in other words, a defibrillator.

The number of publicly accessible defibrillators is constantly increasing. On the geoportal of the Canton of Bern,
, all locations are marked and described on a map. The number of devices available around the clock is now around 750. Smaller is the number of devices that are only accessible temporarily. "We are further along today than we were ten years ago," says Reichlin.

According to Reichlin, the rule of thumb is: If a person can say hello to the paramedic after a cardiac arrest, the chances of survival are over 90 per cent. Otherwise, the question is how well the brain has survived the phase of cardiac arrest. That is why the immediate start of chest compressions is so important, he said. "Every single person in everyday life can make a contribution - and possibly save lives.

But with rapid help, this is always "a journey into the unknown", says Insel cardiologist Reichlin. In fact, very few people survive a cardiovascular arrest if they are not in hospital. In Switzerland, the figure is around 5 per cent. According to the Swiss Heart Foundation, up to 8000 people are affected in Switzerland each year, i.e. about one per 1000 inhabitants.

"This number could be much higher," explains Peter Ferloni, spokesman for the Heart Foundation. This would be the case if there were more lay people who knew the cardiopulmonary resuscitation technique and could also use a defibrillator. "Because with every minute, the chance of survival decreases by 10 per cent." That is why the first responder networks are so important.

According to the Heart Foundation, the canton of Ticino is the leader in Switzerland. Due to the high number of first responders as well as defibrillators, the chance of survival in the event of a cardiovascular arrest outside the hospital is higher than in the rest of the country, says Ferloni. It is up to 50 per cent. The foundation has no figures from the canton of Bern. Several cantons do not yet have a first responder network.

In the canton of Bern, the initiative for the First Responders came ten years ago from the rescue service of the STS hospital (Simmental-Thun-Saanenland). The association was finally founded five years ago. President Beat Baumgartner is himself head of the rescue service at the STS hospital. "An ambulance takes an average of 13 minutes to reach the scene," he says. In the case of cardiac arrest, that is too late.

Baumgartner would like to see an even denser network of first responders. He envisages 5000 first responders, and his goal is to add one new person every day on average. He is particularly pleased that individual fire brigades are participating. This paid off just a fortnight ago in a case in the Oberland. "The leader of a fire brigade started resuscitation until the ambulance arrived.

His greatest wish would be for the Bern Cantonal Police to also participate in the first responder network. "The police are present in all areas, equipped in vehicles for emergencies and mobile." Many police officers participated privately in the network, but the police as a whole did not. "They would have very fast intervention times without having to neglect their core mission."

But Baumgartner's wish is unlikely to be fulfilled any time soon. "At the moment, there are no plans to join," explains Patrick Jean, spokesman for the Bern cantonal police. The patrols are primarily tasked with law enforcement and preventive presence and are distributed throughout the canton. As a blue-light organisation, however, the police are informed immediately in case of emergencies.

The employees of the cantonal police are trained in the use of defibrillators and are regularly trained in first aid, says Jean. When appropriate, a patrol can also be called in without being part of the first responder network.

First Aid in the Canton of Bern - The chances of survival in the event of cardiac arrest are steadily increasing |

Author: Johannes Reichen, Photo: Raphael Moser
Source: Thuner Tagblatt