While automated external defibrillators may improve the chances of surviving a cardiac-arrest, experts cautioned that cardiopulmonary resuscitation is still crucial during emergencies.

An AED such as those installed around the campus is not always effective in every situation, according to experts.

Dr. Patrick Tan, deputy director of the NUS Health and Wellness Centre and head of Wellness Division, said an AED is used specifically on a person who is “unconscious and does not have any pulse and breathing.”

Tan added that although the AED and CPR are complementary, they are essentially different treatments.

According to Tan, an AED can diagnose the cardiac condition of a victim with a high degree of accuracy, and when required, automatically administer an electric shock to the victim’s heart. CPR is a lifesaving technique involving mouth-to-mouth ventilation and chest compressions, allowing the rescuer to manually “take over the function(s) of the heart and the lung(s).”

Contrary to the common misconception that an AED is used to revive a stopped heart, Tan said, an AED is useful only when the rhythm of the heart is abnormal and chaotic.

“Just to let you know, when a person has no pulse, it is a flat rhythm. Even if you use the (AED) machine, no (electric) shock will be advised,” he said. “The machine only advise(s) you to shock if there a special rhythm called ventricular fibrillation.”

Tan said that while the AED is useful during cardiac-related emergencies, it does not replace the need for CPR.

“(The AED) machine may advise (the) rescuer to continue CPR if (an electric) shock is not advised,” he said. “Therefore CPR should be coupled with the use of AED.”

Larry Kang, a fourth-year medical student, agreed that CPR is crucial.

“Having the defibrillator around the corner is a brilliant idea, which should be encouraged,” Kang said. “But at the same time, more people should learn CPR as well, because defibrillation may not be successful all the time.”

While inexperience with CPR may pose problems to the effective use of AEDs, other barriers also hamper some students’ willingness to use the defibrillators during emergencies.

Pearlyn Tay, a third-year pharmacy major, said she would rather call for an ambulance in the event of an emergency, instead of using an AED.

“You can call it a lack of confidence in using the device (AED),” Tay said.

However, Tan said, responders should not hesitate to use the AEDs on victims who have collapsed.

“For every minute (that has lapsed), the brain cells begin to die. The chance of survival drops dramatically by 10% (per minute),” Tan said. “In 10 minutes, there will be no chance of survival."

According to a speech on Aug. 27 by Associate Professor Ho Peng Kee, Senior Minister of State, Ministry of Law & Ministry of Home Affairs, the average response time for emergency ambulances in Singapore is 11 minutes.

Hence, it is important for responders to start administering CPR and using the AEDs before the paramedics arrive.

Although AEDs come with comprehensive visual and aural instructions to guide untrained responders, several precautions must be taken before attempting defibrillation.

Dharshanth Premkumar, a third-year chemistry major who was a combat medic during his National Service, said both the responder and the victim must be dry, and all metal objects must be removed from the victim prior to defibrillation.

While AEDs can help save lives, the presence of AEDs in public areas can increase the public’s responsibilities during emergencies, according to Tan.

“For example, if you install the machine and the machine is nearby to a collapsed victim, but somehow it’s not being used, then questions will be raised during commission enquiry,” he said.

Another issue regarding the use of AEDs is the potential legal implications if a victim was to die after defibrillation attempts.

Yam Guan Shyh, head of emergency management division of the NUS Office of Safety, Health and Environment, said there would be no legal implication if the responder has followed the instructions accordingly.

Tan said “such lawsuits against the public are rare and rarely successful.”

“So long as you do it in good faith,” Tan said. “Most of the time, even if the case goes to court, I believe that the judges will rule in your favor, unless of course you use the (AED) machine totally wrong.”

Apart from more than 50 fixed AED installations strategically distributed across the NUS campus and satellite facilities, the NUS Office of Safety, Health and Environment also has a portable AED for loaning free for official student organizations’ outdoor activities.

Readers can contact Mr. Yam at 6516-1290 for more information on the AEDs in NUS.

Sidebar
According to Dr. Patrick Tan, deputy director of the NUS Health and Wellness Centre and head of Wellness Division, cardiopulmonary resuscitation comprises of both the respiratory component and the cardiopulmonary component.

If a collapsed victim does not have a pulse and is not breathing, the responder should commence with CPR, which includes chest compressions and mouth-to-mouth resuscitation.

However, if a victim has a pulse but no breathing, the responder only has to commence with mouth-to-mouth resuscitation, which is also known as rescue breathing.

Many organizations, such as the National Heart Association, the St. John’s Ambulance Brigade and the Singapore Red Cross, offer courses in CPR. Upon the completion of CPR courses, trainees can be certified as CPR first-aiders for two to three years.