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Simple actions save lives | Forrest Holcombe | TEDxYCISHK


[Music]
when I was 14 years old I joined my
local volunteer fire department as a
junior volunteer and I was allowed to go
on calls as if I was a full-fledged
fireman I remember one of these first
calls very distinctly I it was a cardiac
arrest and for those of you don’t know
what cardiac arrest is it’s where your
heart stops beating you stop breathing
and your brain stem ceases to function
clinically you’re dead and as we rush
this scene my heart was beating as it is
now very rapidly and we arrived the
scene we tried to do CPR and we found
that unfortunately we could not revive
this patient I left feeling like a
failure we weren’t the firemen that we
were supposed to be big and burly I mean
I’m not burly but big burly saving lives
rescuing people that person had died and
what happened and so I left with all
these questions as to is there anything
we could have done better is there
anything I could have done better what
else could have we have done were the
neighbors too frightened to help did
they feel like they couldn’t help and so
as all these questions we’re kind of
rattling in my mind actually ended up
moving to Hong Kong several months later
and I was looking to express my passion
and so I contacted the fire department
and as you can tell by my very American
accent I don’t speak Cantonese and so
they asked you know do you speak
Cantonese
sorry that’s a fire question they asked
do you speak Cantonese I said nope and
they said sorry we don’t want you so I
spent the majority of my first year in
Hong Kong just fangirling over fire
trucks like that just kind of on
snapchat and I realized that I needed to
do something else I felt like I needed
to do something else so I started do my
research and I found out this really
startling statistic really in a city as
developed as this our survival rate from
sudden cardiac arrest is only one point
two five to three percent that means
that it’s the lowest of any nation in
the developed world so I left thinking
you know I can’t join the fire
department what else can I do so I
started thinking what is the most
dangerous thing I could think of as a
person just moving from America to Hong
Kong and the first thing that popped in
my mind was rugby so I asked my parents
can I
become a medic for the Hong Kong rugby
team and they said can you do that at 16
years old so I typed in a few emails and
then I sent them off and I found out
that you can so I got trained as a medic
right there we worked at the sevens we
do all sorts of work around Hong Kong in
Kings Park and eventually became a first
aid and CPR trainer while this didn’t
directly allow me to address the 3
percent survival rate it did allow me to
become more credible when talking about
the needless loss of life in Hong Kong
yeah I still felt like I needed and
wanted to do more to fix this issue and
so a year ago when I was 17 I founded
the Emergency Medical Response
foundation which is an organization that
seeks to advocate and educate the
general public and the government for
better standards of care for cardiac
arrest in Hong Kong so I want you to
imagine me for one moment that you’re
walking down a street in Hong Kong this
is our average Hong Konger here and all
of a sudden you see him collapse he
falls to the ground
some people they stop and they stare
some people they kind of walk forward
they kind of maybe kick him a little bit
they comment oh maybe he’s drunk no he’s
not drunk he’s not having a heart attack
he’s actually in cardiac arrest his
heart has entered a shaky chaotic rhythm
known as ventricular fibrillation
meaning that his heart is shaking in the
fact that it can’t pump blood to deliver
oxygen to his vital organs
clinically he’s dead remember what I
told you cardiac arrest was your heart
stops beating you stop breathing and
your brain stem ceases to function and
in fact with every minute that passes
his survival chances decreased seven to
ten percent and in Hong Kong a city
where the ambulance response times over
12 minutes that means he would be 120
percent dead so obviously there’s an
issue death he moved the other issue is
that he most likely never saw it coming
and displayed no symptoms prior to his
arrest so while we used to think that
cardiac arrest represented the end death
we can’t go beyond death we are now
learning that we can go beyond the
limits of what we thought was medically
possible and we can bring people back
from the jaws of death we can bring them
back to life and the coolest thing about
this for me is that it’s not just for
the medical professionals it’s not just
for the doctors and the nurses and
paramedics it’s for me and you we have
the ability to bring people back to life
I don’t know I think that’s exceptional
I think it’s really cool unfortunately
currently this man is dead and he’s
becoming more and more irreversibly so
as every minute goes by and in Hong Kong
we aren’t doing anything we aren’t
responding to him we just walk on we go
about our lives and unfortunately this
is an all too common occurrence in Hong
Kong he’s dead and we witnessed 58 to 72
percent of these wit of these incidents
and in fact 40% of them actually occur
in our homes so our families and our
friends they’re dying yet we’re not
doing anything our bystander response
rate for CPR that hard and fast
compression of the chest it’s only 20%
so where’s the gap in fact in a 2015
study conducted by Griffith University
in Australia and several other Hong
kong-based organisations we learned that
forty four point three percent of Hong
Kong secondary school students they
think that learning CPR is not necessary
so we’re missing something so I want you
to think for a minute when you think
about CPR something that can double or
even triple the survival rates of this
man can bring it up from a one point two
five to three percent three percent
survival rate in Hong Kong to a three
percent to six percent survival rate and
I know that seems low but it’s a big
difference when you start thinking about
all these people what’s stopping you
what is preventing you from responding
to this man whereas our empathy gone as
a society we have to stop defusing
responsibility amongst ourselves and
it’s time that we take action so I want
you to think once again what’s stopping
you if you were to see something like
this happen what would stop you from
saving the life of this person this
someone who has a heart just like you
and like me it beats the same way why
should he die when I live so how much
you think science actually says that
there are probably a few things that
went through your mind most of you you
probably didn’t even notice you’re a
little too focused on me and I’m very
charismatic but yeah you just kept
focusing on me you didn’t even think
about it the second thing is you were
scared of getting sick yeah it’s a
pretty good fear but I’m going to show
you a way where that doesn’t have to be
a fear a lot of you lacked confidence
understandable if you don’t have
training you don’t want to hurt the
patient you don’t want to make a mistake
understandable
or a lot of you fear legal consequences
these are all really good fears but I
want to address these fears one by one
and offer you some life-saving
world-changing advice first of all let
me tell you that those people that tell
you that responding to a person that
doing CPR are pushing on the chest hard
and fast to stimulate blood flow to
deliver oxygen to the vital organs the
people that tell you that that is hard
that it’s complicated that it’s not
meant for me and you it’s only meant for
the doctors and the nurses they’re wrong
CPR is very very easy so at this point I
haven’t responded to this man here on
stage he’s my brother by the way I’m
really sad I haven’t responded to this
man here on stage yet so I want to take
a moment and I want to turn the clock
back and I want to see what it would
have been like to have responded to him
how can you make a difference how can
you do CPR and I’m gonna give you a
brief demo fun fact he’s not actually
dead and you can’t do CPR on a live
person so I have a mannequin and I’m
going to show you exactly how to do CPR
so you can be prepared to deliver this
life-saving world-changing procedure if
you were to come upon it so we have some
steps in CPR the first thing is I have
to check that the scene is safe I always
like to do a little jazz hands
well jazz hands scene safety there’s no
hazards around me I’m not gonna become
another victim the next thing is you
have to check for responsiveness so my
brother’s name is Ellis so I’m gonna
pretend I know this guy I’m gonna say
Alice Alice Alice can you hear me can
you hear me can you hear me no response
I’m like ooh that’s that’s bad all right
so I got a check for breathing now all
right so what I’m going to do is I’m
gonna do what we call look listen and
feel I’m gonna put my cheek down to his
face I’m gonna head tilt and chin lift
and I’m gonna look down his chest I’m
gonna look for the rise in the fall in
the chest I’m gonna listen I’m gonna see
if I hear any breaths then I’m gonna
feel I’m gonna see if I feel any breaths
coming out of his airway well the
answer’s no partially cookies plastic
but in real life the answer would be no
as well so I realized what I need to do
is I need to call 9 9 9 and I need to
start CPR and so those of you you know
you probably hear about the 12-hour CPR
training course this is about to take 30
seconds so here we go I call 99 I say
hey you go call 999 and get an AED all
right
I’m gonna take my hands I’m gonna
interlock my fingers just like this I’m
gonna place it right in the middle of
the chest in between the nipples and I’m
gonna take it and push hard and fast
pushing out about 100 to 120 beats per
minute and it’s a depth of 5 centimeters
so you ready here we go we don’t stop 1
2 3 4 5 7 8 9 and I would do this and I
go on and on and on and on until help
arrives or until he comes back to life
we don’t stop so I’ve shown you this is
CPR this is how you can save a life I
have a dream and it sounds cliche but I
have a dream where over 50% of people
survive sudden cardiac arrests out of
this dream that’s shared by sudden
cardiac arrest researchers paramedics
physicians nurses medical professionals
worldwide but right now we have to face
this reality head-on and respond with
lights on and sirens blaring to use an
ambulance reference we have to face this
reality and we have to wonder what more
can we do
so like I just demonstrated the first
thing that you can do is whether you
have training or not you can respond
when you see someone that’s unconscious
and not breathing you can perform CPR
you call 999 then you push hard in the
fast and hard and fast in the center of
the chest until help arrives most people
have a decent amount of oxygen in their
blood immediately following collapse and
your compressions you’re pressing on the
chest can help sustain that until help
arrives you don’t even have to do rescue
breaths you don’t have to do
mouth-to-mouth that you always hear
about so if you’re scared of an
infection your problem solved you’re not
making mouth-to-mouth contact with him
you’re just putting your hands on their
chest and pushing hard and fast if you
are not confident I hope I’ve shown you
that CPR is extremely easy I just taught
you how to do it in 30 seconds you’ll
get a chance to practice later on if you
feel like you might occur you might hurt
the patient well I’m gonna tell you go
ahead hurt him he’s dead you can’t hurt
him more than he already is go ahead you
might even break a couple ribs my break
is sternum but go ahead and try
responding always makes a difference the
worst thing that we can do is absolutely
nothing
so just do it just do it
responding always makes a difference if
you want to know more you can get
training from a local training
organization in Hong Kong and for those
of you who already have training you
need to go out there and just be aware
and start watching and be willing to
give this training be confident in your
ability
so our hindrances are preventing us from
saving over 60% of the people who go in
a Clutton cardiac arrest so obviously we
still need to do more we need to respond
more but we also need to advocate so I’m
gonna ask you to be really really
annoying and I know you’re probably
thinking for us you were annoying enough
get off the stage go down back to where
you came from but no I needed to be
annoying with me I need you to talk
about this issue non-stop I need you to
write letters I need you to sign a
petition I need you to post things on
Facebook these are all things that I
like to do to the government and they
find it very annoying but I need you to
pester them until something changes hold
the government accountable hold the Fire
Service accountable hold each other
accountable in this issue we have a
chance to save so many lives that we
aren’t in fact if we look at Seattle
this is Seattle Washington in the u.s.
they have the highest cardiac arrest
survival rate in the developed world it
took just a group of around 5 people 5
doctors to really get this movement
started they’ve been doing since 1970
this chart is just between 2002 and 2013
and you can see they had survival rates
that rose 26% up to 62 percent that is
absolutely insane but the funny the
great thing about it is it’s not hard to
do we can be the force that changes this
a jump from 3% to 62% Hongkong it seems
ginormous but it’s really really simple
if we take the proper steps so I could
go on and on about all these different
things you could advocate for and
cardiac arrest different things you
could you know ask the government to do
but one thing I want to ask you to
advocate for today when you write your
letters is 999 CPR right now when you
call 999 they aren’t allowed to give you
CPR instructions so remember how
important I talked about CPR being it
can double or even triple someone’s
survival rates or you can wait 12
minutes for an ambulance to arrive you
kind of have to pick and choose you know
and so I want to ask you to advocate for
99 CPR when you call 9 and 9 I want them
to be able to pick up the phone and
say okay sir okay ma’am here’s how you
do CPR and they guide you through on the
phone before the ambulance ever even
gets there you can just imagine the
amount of lives that we would save and
the cool thing is that the resuscitation
Academy in Seattle actually classifies
this as a low-hanging fruit meaning it
requires minimal resources minimal
funding and minimal time this is
something that we can be a force in for
change in we can change this we can
advocate for this change so when you’re
writing your letters tonight when you go
home I want you to write about these two
things I want you to write about a one
point two five to three percent survival
rate and then I want you to say here’s
how we fix it and that’s 999 CPR amongst
other things
so when you bow it all down everything
and cardiac arrest is about timing we
can’t change the size of the rose in
Hong Kong we can’t tell ambulances to go
faster but we can bridge the gap between
the occurrence of an emergency and the
arrival of emergency services in Hong
Kong the survival of people like this
patient here it’s not about the
ambulance service at all it’s all about
you and it’s about me we have to be the
responders I go back to that day in the
u.s. almost daily and I think about that
man who died and I asked myself
questions and I think about the 10,000
more people who died in Hong Kong every
year of sudden cardiac arrest 10,000 and
I think what in the heck am i doing
standing here and waiting around these
are people these are your family members
these is this is you and this is me this
is the person sitting next to you and
they’re dying and do we even care
27 people die every day in Hong Kong
sudden cardiac arrest in fact that’s
more than one an hour to sit on my
iPhone a minute ago and what are we
doing and I it makes me so sad and
disappointed because it’s people it’s
not just a number it’s people and I want
you to think about that the next time
you go and you decide maybe I won’t help
that person whether it be in cardiac
arrest or the purse the old lady
crossing the street I want you to think
about that that person is a heart just
like you and like me regardless of our
race
anything we all have the same heart and
we need to step up and stand up for the
people in this world so I think what
more could have I’ve done what haven’t I
done and what more can I do
you can ask
those questions everyday ask mind about
specifically about cardiac arrest and
that helps me think of new ways to
respond and finally this is a class of
CPR students when we think about it the
responders have to be us they not only
can be us but they absolutely have to be
us we’ve moved beyond a point where we
can just wait on the medical
professional as an aunt sort of stuff
sudden cardiac arrest is the greatest
public health issue facing us today it
can strike a person anytime anywhere and
at any age so the medical professionals
we can’t wait anymore we can’t wait for
the ambulance the responders is
mandatory that the responders are us so
the next time you see a guy collapse in
front of you see a young lady collapse
in front of you do something stand up
and be a lifesaver
thank you
[Applause]
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