Saving lives with every beat: A defibrillator in every building

An editorial in the Malta Medical Journal penned by respected paediatrician Simon Attard Montalto calls for the mandatory installation of automated external defibrillators (AEDs) in public spaces and for CPR training to be made compulsory for staff in large institutions.

These recommendations are based on the crucial role of immediate bystander intervention in improving survival rates for cardiac arrest victims, especially in Malta, where delays in response remains a major issue.

With ambulance response times often exceeding 10 minutes, the editorial emphasises that every minute of delay in initiating CPR reduces the chances of survival by 10%. As such, timely bystander intervention, supported by accessible AEDs, is crucial.

The editorial points to alarming statistics from 2016, noting that while 71% of cardiac arrests were witnessed by bystanders, only 39% of these incidents saw any form of intervention, and just 9% involved bystander use of a defibrillator. The survival rate for out-of-hospital cardiac arrests at that time was a mere 6%. While updated figures are not provided, these numbers underscore the importance of expanding public access to AEDs and further enhancing CPR training.

One key recommendation is the mandatory installation of AEDs in all public buildings, including schools, churches, cinemas, and other venues with significant foot traffic, as proposed by the Malta Resuscitation Council. To accomplish this, the editorial proposes that planning applications for such establishments should include requirements for the installation of AEDs.

In addition, CPR training should be made mandatory for staff in large institutions, ensuring that trained individuals are always available in case of an emergency.

However, the editorial also celebrates the greater awareness and increased preparedness achieved through initiatives undertaken in the past decade. These include widespread training programmes by the Malta Resuscitation Council (MRC), the Red Cross, and other organisations, which have helped train over 10,000 individuals across Malta and Gozo. These trained individuals include healthcare professionals, students, teachers, sportspeople, and even children. Efforts such as the European Resuscitation Council’s World Restart a Heart Day, and the Kids Save Lives campaign have raised awareness and expanded training among the general public, focusing on those most likely to witness a cardiac arrest.

Furthermore, the MRC’s introduction of the children’s book Fibrillu, which teaches CPR through an illustrated story, has been a milestone in promoting life-saving skills to young audiences. Distributed to schools, this book aims to empower the next generation with the knowledge of how to act during emergencies.

The collaboration with UEFA on the ‘Get Trained, Save Lives’ campaign has also captured significant attention, especially among sports fans, highlighting how prompt CPR can mean the difference between life and death. However, the Malta AED-locator app, designed to help users find available AEDs in emergencies, has seen limited uptake, with too few AEDs registered for optimal public access.