To further improve the public’s efforts in saving the lives of cardiac arrest victims prior to the arrival of an ambulance – the Singaporean Health Ministry has developed a new device, called the CPRcard.

The CPRcard is just about the size and thickness of a credit card (hence, the name) – and fits easily into most wallets or pockets. This tool provides users with immediate feedback regarding chest compressions and could boost the confidence of those performing cardiopulmonary resuscitation (CPR) in dire situations.

Thousands of cards given out to assess and improve CPR quality

Prior to the commencement of CPR, rescuers are to place the battery-operated CPRcard on the victim’s chest. During chest compressions, users will be notified if the compressions are deep enough and at an appropriate pace for efficacy.

Roughly 4,000 CPRcards have been distributed since late 2016 and the Health Ministry’s Unit for Pre-Hospital Emergency Care (UPEC) aims to distribute another 11,000 devices by August 2018. All 15,000 cardholders will be part of the world’s first community trial to assess if the devices have supported the development of public confidence in administering chest compressions and have generated high-quality CPR.

UPEC medical director and a Singapore General Hospital emergency physician, associate professor Marcus Ong remarked that researchers would also follow up with cardiac arrest survivors to see how they are doing under the two-year study.

Experts can analyse data from memory chips

On 11 June, 200 Choa Chu Kang residents who underwent training received a CPRcard each. These devices were produced in collaboration with Norwegian medical equipment company, Laerdal Medical. All cardholders are required to download the myResponder app so the Singapore Civil Defence Force (SCDF) can alert them to cardiac arrest cases nearby, explained Ong.

Each card is equipped with memory chips to allow experts to provide rescuers with feedback on their actions, collect data on the average quality of bystander CPR and determine whether responders are appropriately trained.

“In the past, we had no way to know what a layperson was doing when they started bystander CPR. This is the first peek we are getting into what is going on,” said Ong.

The CPRcards have been used in six actual cases so far. Ong added that collective data from the real-life responses revealed that bystanders tend to deliver chest compressions too quickly, at a rate of up to 140 a minute – faster than the ideal of 100 to 120.

“The American Heart Association’s campaign for CPR is ‘push hard, push harder, push faster’. Maybe the message for us in Singapore ... is ‘relax, push harder, push at 100 (compressions) per minute’,” he continued.

The CPRcard battery lasts for two years; the same duration of a first-responder certification. With continuous use, the battery lasts for 30 to 40 minutes. When the ambulances arrive, responders are to pass their used CPRcards to the paramedics to receive a replacement.

Authorities hope to develop a well-trained society

In Singapore, over 2,000 cardiac arrests occur out-of-hospital annually. A mere 40% out-of-hospital cardiac arrests here receive bystander CPR before paramedics arrive. The rate is up to 80% in some countries.

A 2010 census depicts that about 10% of the public has current CPR training. Ong said that the target is to have 20% of the population trained in CPR or in the use of automated external defibrillators.

Health Minister and Member of Parliament (Chua Chu Kang) Gan Kim Yong said the CPRcard will be rolled out to other constituencies over time. “To do (CPR) correctly is also important to ensure the CPR they administer is effective in saving lives, while waiting for the arrival of the ambulance and SCDF team,” he added.

Gan’s CPRcard target score: Chest compressions delivered at the right pressure and rate 95% of the time. A score of 80% and above is considered good. MIMS

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