More Responders, One Shared Purpose: Saving Lives

From 1 April 2019 onwards, more responders will be deployed for cardiac arrest cases to ensure higher survival rates.

Three weeks ago, Warrant Officer (WO) 1 Zane Ang responded to an emergency maternity call towards the end of his shift at Alexandra Fire Station. 

“When we reached the patient’s home, the baby had already been delivered,” the 30-year-old Paramedic said. “We first assessed that the baby was in good health before attending to the mother.” 



Their professionalism and care were much appreciated. Recalled WO1 Zane: “We assured the mother that both her and her baby were in good hands, and she said to us, ‘Thank goodness you guys are trained to handle this!’”

Emergency maternity calls, traffic accidents, cases of cardiac arrest – these are just some of the medical emergencies that Paramedics from the Singapore Civil Defence Force (SCDF) attend to every day. In 2018 alone, SCDF responded to over 187,000 calls.



To ensure that life-threatening cases are able to receive quicker attention and treatment over non-emergencies, SCDF launched its Tiered Emergency Medical Services (EMS) Response Framework in April 2017. Under this system, calls are prioritised according to the seriousness of a patient’s medical condition. 

This month, as part of Phase Two of its EMS Response Framework, SCDF introduced the use of High-Performance Cardiopulmonary Resuscitation (CPR) for cases of cardiac arrest. High-Performance CPR has been shown to raise survival rates by reducing pauses between compression cycles during CPR. 



To deliver High-Performance CPR, SCDF has also enhanced its response to cardiac arrest cases. “Previously, we attended to cardiac arrest cases as a team of four – one on a Fire Bike and three in an ambulance,” said WO1 Zane. “The Fire Bike allowed our responder to get to the scene sooner and begin CPR and defibrillation before the ambulance crew arrived.”

From April 2019 onwards, in addition to this four-person team, SCDF will deploy four additional responders via a Fire Engine, Red Rhino or Fire Medical Vehicle. “Each of these responders is given a specific role in performing High-Performance CPR,” explained SCDF Chief Medical Officer LTC (Dr) Shalini Arulanandam. “This minimises the interruption to compressions during CPR, which improves neurological outcomes and raises survival rates.”

For example, the Fire Biker who arrives at the scene first. Once other responders arrive and take over CPR, the Fire Biker will take notes of the situation and find out about vital personal information such as drug allergies and contact details of family members. To ensure high-quality CPR, two responders will take turns to administer chest compressions. 


Currently, responders at four fire stations and one fire post have been trained to administer High-Performance CPR. This number will grow as more firefighters in other stations are trained in High-Performance CPR, with training expected to be fully implemented nationwide by March 2021. 

WO1 Zane explained that while the principles for attending to cardiac arrest cases remains the same – early CPR and defibrillation – the resources and process involved have now been enhanced, for better patient survival outcomes.  

“In the past, it was one ambulance crew managing everything at a scene," he said. "But now, there are more of us, and each has a specific role. That enables the ambulance crew to focus on advanced interventions, which translates into higher survival rates!”