A Q&A with Dr Janet Bray

Adjunct Associate Professor Dr Janet Bray is a Heart Foundation Fellow and Senior Research Fellow at Monash University’s School of Public Health and Preventive Medicine. She is also Associate Director of the Australian Resuscitation Outcomes Consortium (Aus-ROC) at the NHMRC Centre of Research Excellence.

Dr Bray and her team are currently analysing the results of a review of more than 175 triple zero call recordings in cases of cardiac arrest where the patient did not receive (cardiopulmonary resuscitation) CPR from a bystander. The findings could help improve bystander CPR rates and save hundreds of lives in Australia each year.

How did you get into research?

I got into research following a career as a critical care nurse. I wanted to continue to make an impact on patients’ lives and I saw this as a great way to do it on a large scale.

I was working in a hospital and we were trying to improve the processes of the patients coming through emergency department when they were having an acute stroke. In doing that I uncovered that patient delay – the period from when symptoms first begin until they arrive in hospital - was quite significant.

I wanted to look at why that that was occurring so I launched into a PhD looking at factors related to pre-hospital delay and stroke.

What were some of the key findings of your PhD?

One of the key findings was that people were taking a long time to recognise the symptoms of a stroke in themselves and others. We also did an evaluation of the Stroke Foundation campaign as part of that process and we found that people who had seen that campaign were more likely to present to hospital faster.

It was incredibly rewarding to know that these large-scale campaigns, which can be quite expensive, are actually making a large impact across Australia.

How important was funding from the Heart Foundation for your work?

Much of my career has been funded by the Heart Foundation – my PhD, my post-doc and now my Future Leader Fellowship. This has allowed me to look at ways that we can improve the public’s recognition and response to acute cardiovascular symptoms.

Without the Heart Foundation support, I would probably be working for someone else rather than pursuing my own independent research career so it’s enabled me to pursue this line of research.

What are you currently researching?

I’m currently working on a study which is exploring regional variation in rates of bystander CPR. We uncovered that 40 per cent of cardiac arrest patients received bystander CPR and that only increases to 60 per cent if you see someone collapsing and having a cardiac arrest.

We wanted to uncover why that’s occurring and in doing so we uncovered that bystander CPR rates were varying quite significantly between regions as small as neighbourhoods that were right next to each other.

The Heart Foundation Vanguard grant that I got has allowed me to measure CPR training rates and we found that regions that have low bystander CPR rates also have lower rates of CPR training.

We then listened to the emergency calls from those regions with low bystander CPR to see if we could uncover the barriers to performing CPR and we found that even though when you call up 000 and you get bystander CPR instructions down the telephone that these calls in these regions weren’t progressing to that point.

What progress and discoveries have you made?

Some of the barriers we identified around why people don’t provide bystander CPR are communications issues, a lack of confidence and the emotional state of the caller.

The people calling 000 were having large difficulties in identifying that a person was actually in cardiac arrest.
Some people were calling up 000 from a landline and the person having a cardiac arrest was in the other room so they were having to run backwards and forwards and do these checks with the person so that was a barrier and that took up a lot of time as you can imagine.

For other people, there was a lack of confidence in knowing what to do so some people progressed through to the CPR instruction part of the call and didn’t feel confident or comfortable at all performing CPR.

Why is it important that bystanders perform CPR until an ambulance arrives?

We know that CPR doubles a person’s chance for surviving a cardiac arrest and any attempt is better than nothing.
Finding someone in arrest, because they essentially are dead and they look quite still, can be a heightened experience, to say the least, and people do get quite distressed by that, but having training and knowing what to look for and knowing what to do can help with that, we believe.

CPR training improves a person’s confidence to perform CPR and their ability to identify cardiac arrest. You can be CPR trained on the internet, you can get take-home DVDs or you can go through a more formal process of a first aid course. Anyone can learn CPR these days and we believe that everyone should.

Do you have a message for Heart Foundation supporters?

The Heart Foundation helps to fund research programs like mine.