- Only 37% of Thais are aware of proper basic life support procedure
- 69% claim that they are willing to provide CPR to someone who is suffering from SCA, but they are not capable of performing CPR due to a lack of adequate knowledge
- Around half of Thais know about AED devices, but two-thirds of them do not know how to use them properly
A recent study on Thais' awareness and readiness to provide basic emergency life support (BLS), which includes performing cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED), if required, when sudden cardiac arrest (SCA) occursI, revealed that most Thais recognize the importance of AEDs in public spaces, and some already received first-aid training before. However, only 37% of the respondents know the proper BLS procedure.
With 2,011 respondents aged 18 years and over, comprising 49 percent of male respondents and 51 percent of female respondents, the survey found that about 50% of Thais know someone who suffered a heart attack or SCA, and 69% claimed that they are willing to provide CPR to someone who is suffering from SCA. However, only 32% of the respondents have learned how to provide first aid treatment to heart attack or SCA victims, whereas more than half of Thais are incapable of providing BLS because they are unsure or might have forgotten about the helping method. Of this total number, 29% already received first-aid training but can't remember, while 39% never learned about BLS.
The study also revealed about 50% of Thais know about an AED device, understanding that the device can help an SCA patient by delivering an electric shock to the heart if needed. 70% of them also know that AEDs come with voice instructionsI. In fact, some AEDs offer integrated real-time CPR feedback on the force and rate of compression. However, 2 out of 3 Thai respondents do not know how to use an AED properly. More than 80% of them agreed that training people on how and when to use an AED on SCA victims is extremely crucial, with over 70% feeling comfortable with using an AED if required when SCA occurs.
In addition, a survey on the Thai public awareness of AEDs also showed that only 35% of the respondents acknowledge that the Thai Ministry of Interior has issued a notice stipulating that high-rise buildings and extra-large buildings in the country must install AEDs in public spaces. 54% said they never see any AEDs in public areas, while only 27% mentioned that they had found AEDs in shopping malls, sky trains, underground metro trains, airports, etc. However, the majority of the respondents (97%) agreed that it is necessary for public spaces to install AEDs.
Dr. Niphon Srisuwanan, a cardiologist in cardiovascular practice, said, "This study sheds light on how Thai people are aware of basic life support knowledge and how self-confident they are to provide such support if they need to help SCA patients. This is critical as one of the key reasons for sudden cardiac death is that these patients did not receive immediate treatment. Without immediate treatment, a victim's chance of survival diminishes by approximately 10% for every minuteII after a collapse. Therefore, the proper first aid treatment is truly crucial in order to help increase the SCA patients' chances of survival before the rescuers arrive."
Sudden cardiac arrest (SCA) is a silent killer that has taken countless lives each year. It is caused by a sudden loss of heart function when the heart is unable to pump oxygenated blood to the body adequately, and a lethal cardiac rhythm is present. SCA can happen to anyone, anywhere, anytime, whether in public or at work. Without immediate treatment, the patient with SCA will likely die within a few minutes. According to the Global Resuscitation Alliance data, the survival rate from sudden cardiac arrest globally is less than 10%III. Meanwhile, in Thailand, as many as 54,000 people die from heart disease each year, an average of six deaths per hour.IV
To help increase the survival rates for SCA patients in the country, Thais urgently need to gain more knowledge about basic resuscitation (CPR) and how to use an AED properly. Studies have shown that if CPR is provided within the first three to five minutes of collapse followed by the first shock delivered by an AED, the survival rates from cardiac arrest can be increased by 75%V. In addition, getting AEDs installed and having them ready to use in public spaces can also help keep the local communities and workplaces safer.
According to Thailand's National Institute for Emergency Medicine (NIEM), when SCA occurs, there are specific steps that we must follow to maximize the chances of survival from SCA, which is called the "Chain of Survival."
All parties involved, both public and private sectors, are also urged to help create a safer environment by installing AEDs in public spaces, especially in the workplace. This aligns with the recent notification in Ministerial Regulation No. 69 (B.E. 2021) issued by the Thai Ministry of Interior, effective from December 2, 2021. The notification stipulated that those high-rise and extra-large buildings in the country must have assistive devices to increase the survival chances of patients with acute cardiac arrest before the rescuers' arrival. These buildings are required to provide an area or location to install the AEDs in an easily accessible indoor areaVI.
The success of the rescuers' actions at an out-of-hospital cardiac arrest (OHCA) is time-criticalVII. With proper knowledge of basic life support of CPR and early access to an AED, everyone can help improve the chances of survival for those suffering from cardiac arrest by providing prompt resuscitation care with a defibrillator, making a difference between life and death.
I Data on the file: A survey to assess Thais' knowledge and readiness to provide basic life support (BLS) when SCA occurs, conducted by the global market research and data analytics firm YouGov.
II Cummins R.O. 1989. From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Annals of Emergency Medicine. 18: 1269-75.
III Global Resuscitation Alliance. Why the GRA Matters. 2021.
IV https://www.phyathai.com/article_detail/1572/th/%E0%B8%A0%E0%B8%B2%E0%B8%A7%E0%B8%B0%E0%B8%AB%E0%B8%B1%E0%B8%A7%E0%B9%83%E0%B8%88%E0%B8%AB%E0%B8%A2%E0%B8%B8%E0%B8%94%E0%B9%80%E0%B8%95%E0%B9%89%E0%B8%99%E0%B9%80%E0%B8%89%E0%B8%B5%E0%B8%A2%E0%B8%9A%E0%B8%9E%E0%B8%A5%E0%B8%B1%E0%B8%99...%E0%B8%AD%E0%B8%B1%E0%B8%99%E0%B8%95%E0%B8%A3%E0%B8%B2%E0%B8%A2%E0%B8%97%E0%B8%B5%E0%B9%88%E0%B9%84%E0%B8%A3%E0%B9%89%E0%B8%AA%E0%B8%B1%E0%B8%8D%E0%B8%8D%E0%B8%B2%E0%B8%93%E0%B9%80%E0%B8%95%E0%B8%B7%E0%B8%AD%E0%B8%99?branch=PYT3
V Ibrahim W.H. Recent advances and controversies in adult cardiopulmonary resuscitation. 2007. Postgraduate medical journal, 83(984), 649-654.
VI http://www.ratchakitcha.soc.go.th/DATA/PDF/2564/E/293/T_0057.PDF
VII Meaney PA, Bobrow BJ, Mancini ME, et al. Written on behalf of the CPR Quality Summit Investigators, the American Heart Association Emergency Cardiovascular Care Committee, and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. CPR quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128:1-19