Page 7 - 106年2月消防月刊(全)

Special Report 專題報導

It is said “An inch of time is worth an inch of gold.”This is usually meant to encourage people to treasure
every moment in their life. Time is also critically important when it comes to saving lives, a few seconds can
mean the difference between heaven and hell. On January 29, 2017, Taichung City Fire Department received
a call from a father surnamed Wang who said his 8-year old son had choked on a drink while he was driving
on National Highway 1 and was suffering convulsions, was unconscious and had stopped breathing. The
dispatcher on the other end of the line sent an ambulance from the 6th Brigade’s Chunshe Station and also
immediately instructed the father how to carry out CPR on his son, stressing that CPR should continue until
the boy woke up or the ambulance arrived. When the ambulance arrived 9 minutes later, due to immediate
and correct resuscitation he had regained consciousness and his vital signs were stable.
One important reason for the successful saving of the boy’s life was actively linking the chain of life. The
chain of life comprises of five elements: early call for help, early CPR, early defibrillation, early Advanced
Cardiac Life Support and post-integrated resuscitation care in hospital. Each of the elements in indispensable
to save life and, with a complete chain of life, the out of hospital cardiac arrest (OHCA) resuscitation success
rate can be increased. From the first link in the chain, Early Call For Help, carrying out CPR (Cardiopulmonary
resuscitation) and AED (Automatic External Defibrillation) after calling 119, rather than waiting for the
ambulance to arrive, is the key to increasing the chance of successful resuscitation. If a dispatcher is able
to instruct a bystander over the phone how to resuscitate a patient, CPR can begin in the first link of the
chain of life. Figures show that every year there are around 20,000 cases of OHCA rescue in Taiwan, with
more than 4000 patients resuscitated (heart still beating naturally two hours after arrival at hospital,) a 20%
success rate. 450 patients recover, leave hospital and can look after themselves, a survival rate of around 2%.
If a dispatcher is, in addition to sending an ambulance, able to guide bystanders how to perform CPR (DA-
CPR(Dispatcher assisted CPR), for every additional 10% increase in the performance of CPR, over 2000
people will have an increased chance of survival annually. For every minute CPR is provided early, survival
rate will increase by 10%m, showing the importance of DA-CPR.
Without having to increase any budget or manpower, fire agencies can achieve concrete policy indicators as
well as saving more lives of citizens. To raise the level of out of hospital emergency care, DA-CPR has been
used for many years, with good results, in advanced countries. To strengthen the emergency dispatch ability
and CPR and other emergency resuscitation technique advice-giving ability of dispatchers of emergency
command centers at every level of fire agency to improve their professional judgment and emergency
response ability, in 20126 the NFA implemented an OHCA Quality Increase Plan. Results have been seen in
terms of increasing emergency care dispatch ability and improving dispatchers’ ability to give CPR advice
over the phone.

消防月刊 2017.2 5