Attacking rural Australia's high heart attack death rates
A disturbing number of rural Australians die from heart attacks, but ambulance officials say putting more ambulances into regional areas is not the solution.
Mortality rates for heart disease outside Australian capital cities are 30 percent higher in men and 21 percent higher in women than in urban areas, says Mr Paul Jennings, Clinical Educator at Rural Ambulance Victoria, in the latest issue of the Medical Journal of Australia.
"Many deaths from heart disease occur outside the hospital and present as sudden cardiac arrest (SCA)," says Mr Jennings, co-author of a study examining heart attack death rates.
Mr Jennings and colleagues compared the survival rate from out-of-hospital cardiac arrest in rural and urban areas of Victoria, and looked at the factors associated with the different rates.
The results showed urban cardiac arrest patients are much more likely to survive, mostly due to a difference in ambulance response times.
"As it is impractical to substantially decrease (ambulance) response times in rural areas, other strategies that may improve outcome after cardiac arrest require investigation," says Mr Jennings.
"Possible alternative strategies … include computerised ambulance dispatch, first-responder and public access defibrillation programs, and home defibrillation in selected patients."
Bystander CPR did not appear to improve outcomes, the study found.
Mr Jennings suggests the number of ambulance staff may also be relevant, as having fewer staff on deck limits the number of interventions that can be performed at the same time.
"One strategy to address this issue is the introduction of a portable machine that performs chest compressions," says Mr. Jennings.
"This device may allow the ambulance staff to focus on defibrillation and advanced life-support measures."
The Medical Journal of Australia is a publication of the Australian Medical Association.