This statistic applies ONLY to developed countries with a long history of promoting bystander CPR, and ONLY to those that receive prompt (within six minutes of cessation of heartbeat) and effective CPR.
Hypothermia related cardiac arrests are the exception – but a very unlikely occurrence in Phuket.
Cardiac arrest victims who do not receive CPR have a near-zero chance of survival.
Of the 45% who survive until hospital discharge, many have permanent neurologic damage, and fewer still will be alive one year later.
CPR is a skill that can be learned by children as young as five years old. A proper course taught by a certified instructor to lay (non-medical professional) rescuers takes about four-to-six hours. Courses should be repeated every two years to maintain proficiency.
One of the most effective and common sense approaches to reduce snorkelling deaths on Phuket, is a requirement for all Marine Tour Personnel, including boat “captains”, to have current full CPR training.
The Problem With “HANDS Only” CPR
One of the more recent innovations in lay rescuer CPR is the “Hands Only” version.
Studies revealed that many people trained to do CPR were reluctant to perform it when confronted with a real life cardiac arrest situations. When asked why they didn’t do it, many were afraid of the rescue breathing (mouth-to-mouth) component of the procedure, afraid they would contract a communicable disease.
A chest compression only version of CPR, which omits rescue breathing altogether, was tested and proven to be almost as effective as the full version, with a very important exception: Hands Only CPR is NOT effective in asphyxiation and drowning cases.
Boat Crew Reports of ‘Reviving’ Victims
Effective CPR which results in ROSC – Return of Spontaneous Circulation, or “Revival” – in a previously unconscious drowning patient requires full CPR with rescue breathing. Unless marine crews are trained in this full version CPR, reports of patient “revival” after being pulseless for an extended time are unlikely to be accurate.
Properly performed CPR is physically exhausting even for trained, experienced rescuers. It is physically impossible for one or two untrained crew members to perform effective CPR correctly for an extended period of time.
In Phuket’s situation, it can be difficult to verify with a medical professional at the receiving hospital whether or not the initial reports of “revival” were accurate. Ambulance EMT’s do write reports on each incident, but these reports may be considered confidential patient information, and therefore difficult to obtain.
It is likely that many of these reports of “revival” declared by untrained tour crews are inaccurate at best.
Unfortunately, most of these victims are not likely to survive to hospital discharge.
This article was provided to The Phuket News by a reader with more than 40 years' experience in emergency medical services and more than a decade working in surf rescues.