Dáil Éireann debate -
Wednesday, 29 Jan 2003

Vol. 560 No. 1

Written Answers. - Ambulance Service.

Phil Hogan

Question:

599 Mr. Hogan asked the Minister for Health and Children if his attention has been drawn to the fact that current international guidelines recommend a time for medical response to cardiac arrest of five minutes; if any ambulance service here can comply with such guidelines; and if he will make a statement on the matter. [27172/02]

Minister for Health and Children (Mr. Martin)

As the Deputy will be aware, emergency ambulance service staff are at the front line of medical and pre-hospital care. It is widely acknowledged that clinical intervention in the first hour or shorter in the case of cardiac arrest can have a major impact on a successful outcome where there is life threatening or indeed any serious injury. The timely intervention of an emergency medical technician, EMT, is a critical part of this emergency response. Emergency ambulance crews often have to provide services in difficult and traumatic circumstances. Not only do they have to deal with the application of emergency care to seriously ill or injured patients but often have to calm and reassure distressed relatives and friends.

The increasing emphasis on the clinical aspects of the EMT's role in emergency medical care is very much in evidence in the development of emergency medical services worldwide. The extensive use of medical priority despatch and clinical audit systems are indicators of this. The ambulance service is in many ways the emergency arm of the health services.

Policy on the development of emergency medical services in Ireland is set out in a number of documents, including the health strategy, Quality and Fairness – A Health System for You, the Strategic Review of the Ambulance Service, 2001, and Building Healthier Hearts, the Government's cardiovascular health strategy. The approach set out in these documents follows the internationally accepted principles of the chain of sur vival, which provides that effective care for cardiac emergencies requires early access to emergency care, early cardiopulmonary resuscitation, CPR, early defibrillation and early advanced care.

The cardiovascular health strategy clearly highlights the importance of patient-centred pre-hospital care involving not only the ambulance service but general practitioners, first responders and the public at large who all have a role to play in providing the right care at the right time. In line with this approach, services are being developed to provide an appropriate level of care in the community to deal with cardiac emergencies. My Department funds a bystander CPR training programme which is organised by the Irish Heart Foundation. This programme aims to increase the availability of CPR skills in the community.

Defibrillation skills now form a part of basic training for all ambulance personnel. In line with developments in technology which allow people to use defibrillators safely with less training than in the past, my Department is supporting a pilot first responder programme which includes defibrillation skills. This project is being undertaken by the North Western Health Board. My Department has also supported initiatives to provide GPs in more remote rural areas with defibrillator and support equipment and training to allow them deal with emergencies in advance of the arrival of an ambulance. These schemes are in line with the focus of the cardiovascular strategy which seeks to put a pre-hospital care network in place based on the principles of the chain of survival. Further expansion of these initiatives will fall to be progressed in the further implementation of the cardiovascular health strategy.

The Deputy will be aware that the pre-hospital emergency care council was established in 2000 and that its primary function is to develop appropriate standards in pre-hospital emergency care. It is in this context that the council is pursuing the development of professional and performance standards for the ambulance services and for ambulance services personnel in addition to the accreditation of institutions providing training for emergency medical technicians.

My Department will continue to pursue policy initiatives aimed at improving key aspects of the emergency medical service to ensure that those calling on the service receive timely and appropriate care.