As the ski season gets underway, doctors in this week's BMJ say that more defibrillators should be placed in ski resorts to help prevent sudden cardiac deaths.
Automated external defibrillators (AEDs) are electrical devices used to restore a normal heartbeat. They are often placed in busy public places like airports and stadiums.
Downhill skiing is the most popular winter sport in the world and is a serious trigger for sudden cardiac deaths in people with a history of heart problems, high blood pressure, or those who are not used to strenuous exercise. There are 12,000 cardiac arrests in public places each year in the UK.
On a recent skiing holiday in Europe, Dr Sarah Davies assisted a man who had collapsed on the slopes. She was joined by two German nurses, one British paediatric nurse, one French dentist and a British nursing student.
All were familiar with the European Resuscitation Council guidelines and, despite language barriers, communicated well because they all knew what they were expected to do. But they were unable to locate a defibrillator in the first aid room.
"We were on the top of the mountain, a cable-car journey from either of the two local towns. The patient remained lying in the snow, as we were unable to move him," she explains.
After eight minutes the emergency helicopter arrived with a defibrillator, and the patient was transferred to the local hospital.
This experience highlighted that internationally recognised guidelines and access to a defibrillator is of paramount importance, says Dr Davies. Research has also shown that non-medical personnel, such as ski patrollers, can be successfully trained to operate AEDs and this gives good weight to the argument that more AEDs should be made available, especially in isolated areas with relatively large numbers of people.
"We therefore support the suggestion that AEDs should be placed in public areas and that non-medical personnel should be trained to operate them," they conclude.