Paul Holland was doing floor exercises after a two-hour bike ride. Forty minutes later his son Xavier found the fit 56-year-old wasn’t breathing.

“He just kept screaming, ‘Help Dad, help Dad’,” says Paul’s wife Anne, a registered nurse. “I knew straight away that nothing could be done.”

Paul Holland died because his heart had stopped beating after a blockage in his left anterior descending artery — known as the “widow-maker” — depriving it of oxygen. Seven years later, Anne Holland’s mission is to protect other families from the same tragedy.

She says cardiac arrest is the low-hanging fruit of emergency medicine. Thousands of Australian lives could be spared every year if people had access to automated external defibrillators and the courage to use them.

Cardiac arrests, electrical disturbances that stop the heart from pumping, are often triggered by heart attacks, circulatory problems that impede blood flow to the heart. Holland says fear of being sued stops people from applying lifesaving electric shocks, even though the machines act only if they detect that the heart needs sparking.

“You can’t hurt someone with a defibrillator,” she says. “But if you don’t pull them out of cardiac arrest, they’ll die.”

Emergency medicine specialist Paul Middleton says just 10 per cent of Sydneysiders who have cardiac arrests when not in hospital survive the experience. Yet the cardiac arrest survival rate in Seattle, Washington, is more than 60 per cent.

Middleton says the US seaport is “top of the tree”, with AEDs everywhere and people obliged to do resuscitation training such as cardiopulmonary resuscitation to get a driver’s licence or attend university. US states Arizona and Minnesota, The Netherlands and other Western territories are not far behind. Tokyo has about 40,000 AEDs across the city, with a registry and smartphone apps to explain where they are.

We don’t even have figures on the number of defibrillators in Australia. Survival rates are only a little higher than the global average of about 8 per cent. Victoria does a little bit better than NSW, while in the Northern Territory the rate is close to zero.

Middleton attributes Australia’s poor performance to a lack of infrastructure. He plans to fill the gap with Take Heart Australia, the non-profit organisation he founded to make cardiac arrest survival the norm rather than the exception. Its mission is to improve each link in what Middleton dubs the “chain of survival”: community skills in areas such as recognising the signs of cardiac arrest, accessing help, and performing CPR and defibrillation.

Generally, people survive cardiac arrests only if they’re defibrillated. It’s possible to bring someone around with chest compressions or mouth-to-mouth, but the main point of these procedures is to keep blood circulating until the defibrillator arrives.

With about 30,000 Australians suffering cardiac arrests each year, THA says a system of Seattle’s calibre could save 12,000 lives annually.

Middleton says doctors, paramedics and nurses can’t do it alone. “It’s the duty of every Australian to be able to save the life of the person standing next to them,” he says.

Holland says cardiac arrests are almost 600 times likelier to kill people than fires, yet fire extinguishers are everywhere. She says traffic safety campaigns have reduced state road tolls from the thousands to the hundreds.

“We’ve got seat belts, drink driving, drug testing, better roads, you name it,” she says.

“There were 249 died on our roads in Victoria last year. Compare that with 33,000 cardiac arrests. It just doesn’t make sense that there’s not more awareness. Your chance of surviving if you’re defibrillated by a bystander is triple your chance if you have to wait for a paramedic.”

Holland’s Urban Lifesavers campaign aims to encourage more AED use. Her book Back in a Heart Beat is due out soon, promoted by a Shock Around the Clock dinner in Melbourne next month. “The objective is to achieve legislative change so that AEDs become as commonplace as fire extinguishers,” she says.

The Australian  Written by John Ross 18 September 2015