You may think that you are more likely to receive life-saving care if you experience a Sudden Cardiac Arrest (SCA) in a crowd or busy area – but the opposite is actually true. This is due to the bystander effect; a natural phenomenon where the greater the number of bystanders, the less likely any individual is going to act to provide help. It’s a complex phenomenon but one we actively need to combat in order to support people in distress.

Understanding the Bystander Effect

When an emergency situation occurs, people are more likely to take action if there are fewer people around. This reaction takes place for a number of reasons, including assumptions that:

• Someone else is already doing something
• Someone else is more qualified to assist
• You may hurt the person further rather than helping if you try assist
• You may be punished (sued or held responsible) if you try to help and fail

This is very different to pluralistic ignorance, which is the fear of standing out, overreacting or looking stupid in front of other people, which may also occur in an emergency situation.

The fact is that human beings are social animals, so if we are in a crowd, we tend to look around and get our cues from what other people are doing. If people are running, a crowd is likely to stampede. If people are doing nothing, we are more likely to continue our day or task as normal. It’s a powerful herd survival instinct that isn’t always a bad thing – for example, you’re more likely to recycle if you live in a community that is strongly eco-friendly, where you feel social pressure to conform. However, in the event where a person needs help – whether it’s because they are being attacked or are in a medical emergency situation, the bystander effect can be deadly.

The Bystander Effect and SCA

In the event of a SCA, it is commonly recognised that the person must receive treatment within 3 minutes. In fact, their chance of survival and minimising brain and organ damage is reduced by 10% for every minute that passes without treatment. As a result, it is essential that we learn how to recognise and actively counter the bystander effect within ourselves in order to save the life of a person in SCA.

How to Counter the Bystander Effect

By learning how to recognise and counter the bystander effect within ourselves, we can react quickly and save a life rather than wasting precious time looking around and deliberating whether or not we are the right person to act. One of the best ways to do this is to visualise this emergency scenario regularly and overwrite your instinctive social programming. Here’s how to prepare yourself to overcome the bystander effect:

• Imagine – You are sitting at a coffee shop/watching your child play at the park/ participating in a sport/going to work when someone nearby suddenly collapses. This helps counter the shock of a sudden emergency event if it does happen nearby.
• Acknowledge your feelings – Run through your feelings of shock, fear and confusion. These are natural feelings (including feelings of wanting to leave the space), and they take valuable time to process. The more practiced we are at doing this, the faster we can turn shock into action.
• Visualise your actions – Run through the actions you would need to take to save this person’s life. You would call emergency services (it’s a good idea to have these numbers clearly logged in your mobile), shout to people around you to fetch an automatic external defibrillator (AEDs are common in many public spaces, including parks, gyms, train stations and workplaces), and then you would perform bystander CPR (you can also provide rescue breaths if you feel confident to do so) and follow the AED instructions.

Taking steps to prepare yourself for this moment like reading up on AEDs and how to recognise different medical emergencies like SCAs, taking a First Aid and CPR course or defibrillator training all help condition you to respond confidently and automatically, overcoming the pressure of the bystander effect.

Ways of overcoming the bystander effect during a SCA emergency include:

• Calling out –Saying the words “That person needs help” out loud can help break the shock and effects of being a bystander in a crowd, helping to mobilise assistance.
• Getting assistance through naming – You can also help others break out of this immobility by naming them out loud. They may be strangers but the act of saying “You in the grey suit, call an ambulance”, “You in the blue dress, go find an AED”, or “You in the black shirt come help me do CPR” can help other people snap into action and provide the support you need to save a life.
• Knowing the chances of survival – Many people fail to act because they fear hurting the person further. But the reality is that without bystander assistance, someone experiencing SCA has a very low chance of survival. You cannot hurt them further. Their heart has stopped and only an AED and bystander CPR can help. Knowing they have no chance without you can trigger the resolve you need to overcome that fear and act.

AEDs and Defibrillator Training in Australia

75-80% of SCA deaths happen away from hospitals, which means that with access to AEDs and defibrillator training, the public can play a vital role in saving tens of thousands of lives each year.

At DefibsPlus, we work to provide public spaces, workplaces and homes with affordable AEDs as well as the training to recognise SCAs and use these simple devices to treat this emergency effectively.

For more information on our products and services, contact us today. Together, we can save lives.