Forum: Having enough AEDs and identifying trained marathoners will help save lives

In Singapore, more than 20 per cent of the population have been trained in lifesaving skills such as cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) usage based on locally published literature.

In the recent Standard Chartered Singapore Marathon, with over 55,000 participants, it can be extrapolated that more than 10,000 people would have been trained in CPR and AED skills.

As Dr Desmond Wai pointed out (

Marathon participants should learn CPR to help save lives,

Dec 5), CPR and the use of AEDs are crucial to survival and he encouraged fellow runners to learn these skills. 

However, learning these skills alone is not enough. A study published in 2017 of cardiac arrest at the Tokyo Marathon analysed 63 cardiac arrests over 15 years. It found that 95 per cent of the 20 cardiac arrest victims who had CPR and AED applied by nearby first responders survived, versus 47.1 per cent of those who had only CPR.

With increasing interest in organised running and endurance events, the Japanese experience holds significant lessons for us. Having available AEDs is a key enabler to survival. 

Brain death starts as early as 4 minutes and having quick access to AEDs from first responders on foot, bicycles or powered mobility devices within a 3-minute reach would help to ensure the runners are promptly attended to.

It is not easy for most event organisers to rent a large enough pool of AEDs to cover a 42km running route but I hope the industry or sports safety-related organisations can consider offering such a rental service to make these events safer. 

Marathon organisers could also consider offering a discount for runners who show a CPR/AED certificate that is valid at the date of the race and who are willing to make themselves identifiable during the race with brightly coloured race jerseys as certified lifesavers.

It is a small cost for organisers to make it easy to identify those who can help and this would benefit those who regularly certify themselves in life-saving skills to keep our community safe. 

It takes a system to save a life
– training the community in life-saving skills, detailed event medical logistics planning and galvanising the participants to action will make a difference between life and death. 

Ng Yih Yng (Dr)