Por Redaccion 
The Emergency Health Center 061, belonging to the Andalusian Health Service of the Ministry of Health and Consumption, ‘secures’ the processional routes of Holy Week in Seville once again, with the collaboration of the City Council of Seville and the General Council of Brotherhoods and Confraternities of Seville. This initiative was presented by the Minister of Health and Consumption, Rocío Hernández, at an event held at the headquarters of the General Council of Brotherhoods and Confraternities in the capital of Seville.
The Minister was accompanied by Manuel Molina, Delegate of Health and Consumption, Francisco Vélez, President of the General Council of Brotherhoods and Confraternities of Seville, Silvia Pozo, Delegate of Health and Animal Protection of the City Council of Seville, and José María Villadiego, Assistant Director of the Emergency Health Center 061 in Seville, among other authorities.
The brotherhoods that process through the city from Palm Sunday to Easter Sunday will be equipped with semi-automatic defibrillators, located inside the floats, to be available to them, as well as to the thousands of people who gather around them during their procession. In addition, the implementation of in-house health services in the brotherhoods will allow them to be the first responders in emergency situations until the arrival of resources from the public health system.
Thus, about 130 non-healthcare personnel from the various brotherhoods have received training in basic cardiac resuscitation techniques during two days held in February and March. With the help of 40 healthcare professionals who volunteered, the members of the brotherhoods have been trained on how to act and intervene in a critical situation while emergency services arrive.
The ‘Cardio-Safe Holy Week’, celebrating its tenth anniversary this year, has provided training in resuscitation techniques and defibrillator use to more than 20,000 people. This initiative, along with the deployment of volunteer healthcare personnel in the processions of all brotherhoods, has improved the quality of care and increased survival in all life-threatening situations.
In this edition, as in previous ones, a total of 40 defibrillators will be distributed among the 70 brotherhoods that procession through the city, to which another 15 fixed defibrillators will be added this year, identified with the ‘Cardio-Safe Zone’ badge, which will be placed in establishments, kiosks, and churches located in high-traffic areas. For this purpose, the collaboration of the Real Betis Balompié and Sevilla F.C. foundations – whose presidents, Rafael Gordillo and Luis Castro, respectively, attended the presentation at the headquarters of the General Council of Brotherhoods and Confraternities of Seville – the provincial group of Red Cross, and Almas Industries company has been enlisted.
The defibrillators have been used, over these ten years, to attend to people who suffered a cardiac arrest during the processional route. In all cases, prior to the arrival of healthcare teams, the intervention of a first responder who applied basic resuscitation techniques and used the nearest available defibrillator was crucial in saving the lives of many of these individuals, who were later discharged from the hospital without sequelae.
Special Health Device
The Emergency Health Center 061 will establish a special health device during Palm Sunday, Maundy Thursday, and the Early Morning, equipped with a mobile ICU from 061 with a doctor, nurse, and emergency technician, strategically located to intervene rapidly in case of need, and a control room operator in the CECOP of the City Council for coordinating the usual health resources available in the public health system. During the Early Morning, the special device will be complemented by a logistical support vehicle from 061, prepared to assist multiple victims.
Furthermore, throughout Holy Week, two mobile advanced care teams (EMCAs) will be added, medical attention at the fixed urgent care points of the Ronda Histórica and Cachorro health centers will be reinforced, and five more managers will be incorporated into the emergency and dispatch coordination center to handle calls. All these resources will be complemented by the usual ones from the Andalusian Health Service to attend to emergencies in the capital: four emergency healthcare teams, two advanced coordination teams, and one basic life support team, all from 061, in addition to six mobile teams from the primary care emergency service (SUAP) and seven ambulances from the urgent transport network.
Action in Case of Cardiac Arrest
Each brotherhood has healthcare personnel and members trained by 061 to act immediately in case of witnessing a cardiac arrest during their processional cortege, with the aim of reducing mortality and sequelae, before the arrival of healthcare emergency teams. These teams will be the first responders, identifying life-threatening situations versus milder emergencies that, in the vast majority of cases, they will resolve themselves.
Proper care for cardiac arrest involves the early application of a series of actions known as the ‘chain of survival’ which includes, in this order, recognizing the situation and activating the healthcare emergency system, immediately starting basic life support maneuvers, early electrical defibrillation, and rapidly implementing advanced life support techniques.
In the event of a cardiac arrest, it is essential to start basic cardiopulmonary resuscitation maneuvers quickly while awaiting emergency services. International recommendations indicate that one of the main strategies to reduce mortality in patients who have suffered a cardiac arrest is to educate the general population on the basic measures to apply to these patients while awaiting healthcare teams, which have been shown to increase survival rates in these cases.
‘Cardio-Safe Zones’
Andalusia currently has 1,172 ‘cardio-safe zones’, 129 of which are in Seville. To facilitate a rapid intervention in such situations, the Ministry of Health launched an initiative in 2013 to promote basic life support training and the use of automated external defibrillators among Andalusian organizations, recognizing all institutions that met the requirements set out in the Order of June 4, 2013 (Boja 113/2013), as ‘Cardio-Safe Zones’.
The Emergency Health Center 061 is responsible for managing and registering organizations that have this certification, which confirms that these institutions have trained their professionals and placed defibrillators in their facilities, in the appropriate number and locations, as established in the regulations to comply with Decree 22/2012 of February 14, which regulates the use of semi-automatic defibrillators in public places outside the healthcare setting and the handling of the equipment by non-medical personnel.
The registry of defibrillators of the Ministry of Health and Consumption indicates that in the province of Seville, there are 1,658 automated external defibrillators (606 in the capital) that, due to their characteristics and operation, can be handled by non-healthcare professionals. These automated external defibrillators (AEDs) are located in public institutions, recreational areas, and places prone to large gatherings of people, as well as in private companies, so that in the event of a cardiac arrest, appropriate first aid can be provided while emergency services arrive.
Requirements for a ‘cardio-safe zone’
The certification of a ‘Cardio-Safe Zone’ is granted to institutions that request it and meet the established requirements. Among them, it is highlighted that applying institutions must have a specific number of semi-automatic external defibrillators in their facilities, operational and in a suitable location, enabling at least 75% of users to apply defibrillation within three minutes.
Likewise, it is also verified that there is a training plan for personnel offered by entities belonging to the Spanish Council of Cardiopulmonary Resuscitation, and that there is an adequate maintenance plan for the installed AEDs, in accordance with their technical specifications and manufacturers’ recommendations. It is also considered essential that the company or institution establish an internal activation protocol to deploy and use the AED while activating and awaiting emergency healthcare services.