Response time has a direct effect on survival. Early defibrillation is the critical factor in survival following a cardiac arrest (a health
problem which is extremely prevalent in South Wales). In 1979 Eisenberg et al. showed that timely intervention of a rescuer and the rapid availability of a defibrillator gave the best results for those suffering from ventricular fibrillation. For each minute that passes once the heart stops; the chance of re-starting the heart (by delivering a shock using a defibrillator) reduces by up to 10%. For people living in Cardiff this means that if the ambulance doesn’t arrive until 8 minutes after a heart attack, the chances of the paramedics being able to revive the patient is as little as 20% - 8 out of 10 casualties will not survive.

In the early 1990’s, literature described the advent of ‘local resuscitation ambulances’ and ‘ordinary ambulances equipped with a
defibrillator and crews experienced to use it’. Today, not only is it usual for all ambulances to carry defibrillators (with all paramedics trained in their use) but it is not unusual for automated external defibrillators (AEDs) to be used in the community by First Responder teams.

The Resuscitation Council (UK) has advocated and promoted the use of the ‘Chain of Survival’ (since its conception by the American Heart Association in 1991) in an effort to optimize responses to individuals experiencing unexpected cardiac events. A combined approach by Chamberlain and his colleagues has been to train paramedics to a high level of expertise in cardiopulmonary resuscitation, defibrillation and drug administration together with training programmes which continue to alert the general public to the actions to be taken in such emergencies. Training of First Responder Teams is the next step in these training programmes for the general public. It is our hope that we will be able to help reduce response time and save lives in Cardiff.

This first responder scheme is not intended in any way to replace the services provided by the ambulance service; but rather to complement it. It does however have the potential to be a valuable and important resource which could significantly influence the chances of survival of the acutely unwell (in particular heart attack victims in Cardiff).