Public Safety Committee on Oct. 2nd, 2018

[Philip Girouard]

You mentioned manufacturing AEDs, but it is not as simple as what we think. An AED is more than a bunch of batteries, a wire and a button. A monitor is linked to the device, which reads the arrhythmia or the heart's electrical impulses. It is a very complicated process.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Probably established technologies elsewhere most likely are the answer.

[Philip Girouard]

Exactly.

[Jocelyn Grondin]

You should also know that there is no learning curve for manufacturing these devices. The first AED off the production line must be of the best quality. Before embarking on such a venture, we must be sure of what we are doing. When you are about to push a button to resuscitate someone, you do not want to hear that there is a bug in the program, or that it is the first device off the production line and that the next ones will work better.

I think it would be risky to get into the manufacturing of defibrillators. Instead, I think we should turn to a Canadian company that already manufactures them.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

I have a final question on training. If we're thinking forward and we say more people need to be trained, what's the minimum age of somebody to be able to understand this technology and handle it?

Can we train schools, children in schools, young people, and if so, at what age would they be competent to handle the machine?

[Shawn McLaren]

We begin our first aid and CPR training at age 13. We do have courses that go as low as grades 1 and 2 but our official youngest age is 13.

[Sven Spengemann, Liberal, Mississauga—Lakeshore, ON]

Thank you.

I think that's my time.

[The Chair, Liberal, John McKay]

Thank you, Mr. Spengemann.

Ms. Leitch, welcome to the committee.

You have five minutes please.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Thank you very much, and thank you, everyone, for taking some time today.

My understanding is that we're all in agreement on moving forward with this motion. We appreciate your coming today.

Maybe I could ask you, Mr. Stanzel, to outline for the committee just what is so important on the time frame. I'm an orthopaedic surgeon. Like yourself, I appreciate the time frame of being able to implement these things.

Can you outline for the committee and also for the record why the critical time zone is the time frame that it is?

[Andrew Stanzel]

As I said, CPR only lengthens the amount of time that you're in that VTach or VFib. Those are the only two rhythms that can be shocked. Unlike TV where they're shocking somebody who has flatlined, that's not the way it works. When you're flatlined, drugs may get you out but you're not getting shocked back. My wife is a nurse too. We tend to get irritated by medical shows.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Welcome to the club.

[Andrew Stanzel]

The faster that AED gets on, the better chance you have of getting that person while they're still in that shockable rhythm. Once they're outside of that shockable rhythm, your only chance at that point is drugs, and the general public is not carrying epinephrine or vasopressin, or things like that, to try to restart the heart.

Like I said, the amount of time you stay in that frame, it's about four minutes before you start having brain damage kick in. The heart can be gone sooner than that. The faster that AED gets on, the better chance of survival you have. Once you're out of that critical two arrhythmias, that's it, you can't resuscitate them back using AED anymore.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

One of the things that Mr. Spengemann had raised before is just whether or not AEDs are available. Just so you're aware, Medtronic, which is in your riding actually, is one of the few producers globally of this device. I'm sure they'd be delighted to help you out on them.

This question is for everyone. Where do you see those most frequently used occasions?

I think it was you, Shawn, who mentioned that someone was crossing the finish line of a big marathon and it had to be used. Obviously, you each see different contexts. It gives us some idea, not just for first responders but actually for volunteers out there in the field. Where should we have these? What's the most frequent location where you see the need for the use of an AED?

[Jocelyn Grondin]

We could have AEDs in any location where physical activity takes place. It has been documented that the places where AEDs are most used are centres where intense physical activity occurs, such as hockey or similar sports.

When municipalities ask us where to install the device, we suggest that it be put in places where people gather, especially where there are people of a certain age. I am referring to community centres, seniors' homes and places where there are more people likely to experience cardiac arrest.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Would you like to add something, Mr. McLaren?

[Shawn McLaren]

I would agree. Sometimes you want to consider where age is involved as well. We've worked with the Legion to get AEDs into the Legions, and Lee Valley Tools. I like to shop at Lee Valley Tools, but the population that shops there is maybe a little older than me.

Again, with the physical activity, I would consider age as well and anywhere where there's a large grouping of people. We had an incident about a year and a half ago where someone brought someone back at IKEA. Just because there's a large concentration of people, that's a great spot for an AED.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

I could see people being quite wound up at IKEA, particularly at the exit.

[Voices]

Oh, oh!

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

One thing has crossed my mind. We frequently get asked to fund opportunities for various things, whether it be at this committee or with other motions and items that are put forward for parliamentarians. We often don't have the evidence to make this a non-debatable issue.

Has there been some thought—particularly if you're in the Ottawa area where AEDs are used in abundance—of working with the Ottawa general hospital, with CHEO, and with individuals who would be able to provide some evidence base for the critical time frame for being able to use AEDs and the impact they're having on the society here in Ottawa? Is there something to provide individuals like us who are making these decisions evidence so this becomes, for lack of a better term, a no-brainer decision, so that the evidence speaks for itself?

You can say there isn't. It's okay.

[Andrew Stanzel]

We don't have those numbers in front of us. The person who would have the numbers would probably be in the Ottawa Paramedic Service. Everyone who is resuscitated in the community—again, you're only seeing people that it's successful on—are brought to the heart institute, to the CCU there, and that's where they have their after cardiac arrest care.

Again, you're only going to see the segment of the population who survived. They may be able to provide some information around whether AEDs were used and the time frame. We don't have those numbers.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Thank you very much for your time today.

[The Chair, Liberal, John McKay]

Thank you, Ms. Leitch.

Speaking for the final five minutes before we suspend, Ms. Dabrusin.

[Julie Dabrusin, Liberal, Toronto—Danforth, ON]

Thank you.

It has been really interesting to have this conversation. What I'm picking up is that there are really two issues as to how we do this appropriately. One is location and the other is education.

The original motion that started the study was about putting the defibrillators in RCMP vehicles. When I started looking at it....

I actually spoke about this in the House. In a city like Toronto, that's not going to be the location to help people. In fact, U of T engineers did a study and thought it was coffee shops, ATMs and parking locations, because everyone knows where they are. If you know that certain coffee shops all have them, you would know where to run to. That was their study. It hits me that when we're looking at RCMP vehicles, we're really looking at more rural locations. We've talked about gyms and meeting spots, but it hits me that we're talking about RCMP vehicles. We're talking about all the spaces in between.

Do you think that having them in vehicles that are travelling in between those gathering locations.... How does that help? I feel like this is really a focus on a rural issue more than a city's.

[Philip Girouard]

In my area, the Sûreté du Québec is informed only when there is a cardiac arrest. In urban areas such as Victoriaville, police are called more frequently to areas outside the city. That is where we need more help and more AEDs.

Within municipalities, the Sûreté du Québec does not respond because there are first responders such as firefighters and paramedics available. We would not gain any time by calling in a third resource. The need to act quickly really affects outlying areas.

[Julie Dabrusin, Liberal, Toronto—Danforth, ON]

I am trying to establish how we can install AEDs in appropriate places, how we can find good places to install them. We talked about sports facilities and community centres. However, there is also the issue of whether the best place for these devices would be in vehicles. Is that the case in your experience? It is different in cities.