Frequently Asked Questions (FAQs)
What is DARE?
The DARE (Dispatcher-Assisted first REsponder) Programme is an initiative fully funded by Singapore’s Ministry of Health (MOH) and implemented by the Unit for Pre-hospital Emergency Care (UPEC)* to strengthen responsiveness for medical emergencies (out-of-hospital cardiac arrest) and to raise the level of preparedness in the community.
*UPEC was established by the Ministry of Health (MOH) in 2013, to coordinate, monitor and implement various pre-hospital emergency care strategies, including educating and increasing public’s awareness about medical emergencies and the importance of community responsiveness.
Why is DARE important and who can learn?
Sudden cardiac arrest is a medical emergency that requires immediate response. In a cardiac arrest situation, the heart suddenly stops beating and there is no blood circulation around the body to the vital organs.
Such necessary response can be carried out by anyone and that is the key message which the DARE programme aims to deliver during the training.
Is there a difference between DARE programme and certified CPR+AED programme?
Yes there is!
Certified CPR+AED programme
45 minutes – 1 hour (depending on training requirement)
Half a day
Comes with certification
Focuses on awareness and building confidence level
|Focuses on competency
|May requires fee
What can participants expect to learn from the DARE programme?
DARE is a 45-minute programme comprising training through educational video and practical session without technical terminologies. This is a simplified programme without certification. Participants are taught how to respond when they witness a cardiac arrest and guide them through step-by-step instructions. The key messages are:
Call 995 and stay on the line (on how to co-operate with the 995 specialist)
Push hard and fast (perform simplified CPR (Cardiopulmonary Resuscitation)
Use an AED (Automated External Defibrillator)
Over 100,000 persons ranging from primary school age children to elders have benefitted from the DARE programme.
I am keen in attending a session. How much does it cost?
As this public education programme is fully funded by Singapore’s Ministry of Health, there is no charge for participants.
How and where may I sign up for a free training session?
You may download the DARE (Learn-CPR) app via the Apple App Store or Google Play and sign up for a training session or visit any of your preferred community centres to enquire about a free CPR+AED course.
Are you able to conduct training sessions for my workplace/condo/religious/tertiary educational institution? What should I take note of?
Yes we are happy to! Please contact our DARE team ([email protected]) to arrange for the training. In the meantime, please note the following information and requirements:
The minimum and maximum class size are 20 and 80 pax respectively per training session;
A large area without tables or chairs (e.g. conference room/ training room) for all participants so that they have space to sit/move/kneel (a picture of the area for reference will be helpful);
AV required – projector, microphone and speakers;
Multiple training sessions could be planned in advance based on the availability of staff and training site (usually conference room/ training room)
Is this CPR+AED programme available in primary and secondary schools?
We are happy to share that the Unit for Pre-hospital Emergency Care (UPEC) has worked with the Ministry of Education to include hands-only CPR+AED training in the physical education curriculum since late 2017.
Primary 5 students are taught to recognise the signs of cardiac arrest and what they should do in such a situation while Secondary 1 students are trained in CPR and on the use of the AED.
Can a male bystander, who has no relation to a female casualty experiencing cardiac arrest, come to her aid by starting CPR & the using an AED on her if there is no other female bystander around at that point in time?
Ustaz Syed Nasir Omar, a religious leader with AlFahmi Services says:
Yes it is alright for a male bystander to dare to call 995, start CPR and use an AED on a female victim (especially Muslims) if there is no other female bystander able to do so. This is because the situation is a desperate emergency case. If there is a female bystander or passerby, she should assist the male bystander in the resuscitation in any way possible. The female bystander can also be a witness too.
Should female bystanders who have no experience in healthcare attempt to resuscitate cardiac arrest victims who may be bigger in size than they are?
Dr Karen Soh, Immediate Past President of the Association of Women Doctors, Singapore says:
Yes we encourage female bystanders to dare to save a heart even if they are not medically trained or are physically small. Anybody can call 995. Any chest compression is better than none at all. Anyone can use an AED as the voice prompts are clear. Do not be afraid just because you are female; you are equally capable of initiating resuscitation.
What if other people criticise me for approaching a person who has suffered a cardiac arrest, if I don’t do it perfectly?
Dr Benjamin Leong, Deputy Director, Unit for Pre-hospital Emergency Care (UPEC) says:
Let this not be a barrier to the victim receiving timely life-saving help. Call 995 and stay on the line, the 995 specialist is trained to guide you through the steps.
Since there is no Good Samaritan Law in Singapore, if the victim I’m resuscitating suffers from a rib fracture or dies, would I be sued by his/her family?
Ms Kuah Boon Theng, Council member of The Law Society of Singapore says:
There are no Good Samaritan laws enacted in Singapore. A Good Samaritan is a rescuer who responds in an emergency when there is no legal responsibility to do so. This excludes healthcare professionals who care for patients in a clinical setting and owe their patients a duty of care. Good Samaritan laws are aimed at absolving rescuers from liability should the rescuer’s attempts to help a stranger fail, or make matters worse. Currently there is little evidence to support the claim that the absence of Good Samaritan laws is what deters would-be rescuers, or that enacting Good Samaritan laws would necessarily encourage more bystanders to help a stranger.
If I attempt resuscitation and the victim passes away, will I be in trouble with the law?
The law requires Good Samaritans to act reasonably. Although would-be rescuers may have noble intentions, they must not behave recklessly or negligently in a way which could cause even more injury. However, there have been no reports locally of successful claims being made against Good Samaritans. A claimant would have to prove that if the attempt to help the “victim” was not made, the “victim” would have been better off. This would be difficult to prove, if indeed the “victim” was truly in dire need of help and intervention.
If I attempt resuscitation and the victim survives but has an injury directly resulting from my intervention e.g. rib fracture, will I get into trouble?
So long as you apply CPR in accordance with proper techniques, there should be no liability, even if the victim were to sustain injuries that are known complications of CPR/external chest compressions, such as rib fractures.
Is it possible for a victim to accuse a Good Samaritan of molest during the course of the volunteer intervention?
So long as the Good Samaritan renders aid in accordance with proper medical techniques, it would be extremely difficult for a “victim” to credibly claim that the Good Samaritan’s actual intent was to molest/outrage modesty.
If there is a cardiac arrest incident and I walk away from it, will I get into trouble?
The law does not impose a legal duty on bystanders to assist someone in danger, unless the bystander was the one who put the victim in danger. This is true even if you are a healthcare professional. However, the standards of medical ethics require a trained medical professional to go to the aid of someone who can potentially be saved by the skills and training which the medical professional possesses.
Why don’t we do a pulse check?
Even some healthcare providers have a hard time telling if there is a pulse within 10 seconds. It is better to give CPR to a person who is unconscious and not breathing normally, who is highly likely to be in cardiac arrest, than to not give CPR to someone who needs it.
If I find a person on a bed, should I move her to the floor so that I have a hard surface under her back?
If you can, quickly move the person to a firm surface (e.g. the floor) to give CPR. Make sure you support the head and neck as you move the person. If you are alone and can’t move the person, try to find something flat and firm (like a piece of board). Slide it under the person’s back to provide a firm surface.
When should I stop CPR?
- The person starts to wake up/move/respond
- Someone else comes to help, and you can take turns to give CPR
- Someone with more advanced training arrives to take over (e.g. the ambulance paramedic)
- You are too exhausted to continue or it is dangerous for you to continue (resume as soon as you are able to)
Why is ventilation not taught?
Any attempt at CPR is better than no attempt. Chest compression only CPR performed by a bystander has been shown to be as effective as conventional CPR with mouth-to-mouth ventilation in the first few minutes of an out-of-hospital sudden cardiac arrest. For bystanders who are not willing/able to perform ventilations, chest compression only CPR is a good alternative.
If the victim is gasping for air and do I still continue CPR?
Gasping is considered as not normal breathing. Please start CPR as soon as possible.
Can I perform chest compression on a pregnant victim?
Yes! The steps to perform CPR are the same. Chest compression are performed at the center of victim’s chest (lower half of sternum bone) and not at the abdomen.
In public places, where are AEDs found and who can access them?
All government sports facilities (e.g. sports stadiums and gyms), most government facilities (e.g. fire stations and police stations, prison link centres, military camps and schools), most major tourist attractions, MRT stations, shopping centres, hotels and country clubs are equipped with AEDs. AEDs are also installed at the lift lobby in every 2-3 HDB blocks.
These AEDs are accessible to anyone who needs them. All laypersons are allowed to use them, but undergoing CPR/AED training is highly encouraged as it will help you to be familiar with them and use it when it is needed. Download the “myResponder” mobile app where there is a function that allows you to search for an AED near you.
For conventional certified AED providers, previously they are taught that, if no shock is advised after AED rhythm analysis, they should check for normal breathing. If there is no normal breathing, to start CPR. For the DARE programme, are bystanders told to check for normal breathing?
Dr Francis Lee, Head of Defibrillation Committee, National Resuscitation Council, Senior Consultant at Khoo Teck Puat Hospital says:
In DARE training, minimum interruption to chest compressions is emphasised. The appropriate time to check for normal breathing is the beginning, when the dispatcher asks to confirm lack of responsiveness and normal breathing, as well as during AED rhythm analysis. If there are still no normal breathing observed and no shock is advised, immediately begin chest compression.
What if there is no AED available?
Continue CPR until Emergency Medical Service (EMS) help arrives, or when the victim starts to wake up/move/respond.
Can I use the AED on a pregnant victim?
Yes! The steps to use the AED are the same. Our priority is to increase the chances of survival in any cardiac arrest victim. There are no scientific papers supporting the result that AED causes more harm when used on a pregnant victim.
What are the dangers the participants must critically take note before the use of an AED?
Participants should take care of personal safety in the environment, and also be aware of potential hazards related to the transmission of electricity if an AED shock needs to be delivered. For example, the patient should be wiped down as best as you can if he/she is rescued from a swimming pool and also the shock should not be delivered in an environment with an active gas leakage. Also precautions should be taken if the patient is lying down on a metal surface as a small amount of electrical energy may be transmitted via the metal surface. Ensure that you are wearing shoes and avoid barefoot contact.