As I sit with accomplished Paediatric Emergency Specialist Dr Jade Kua, discussing what it is like to handle trauma patients, she receives a page over the intercom. Politely excusing herself, she quickly rushes out to attend to a patient.
A few minutes later she returns looking as composed as she did before. From her calm demeanour, one would never think she had just attended to a young woman who was rushed in due to a drug overdose.
Such is a few minutes in the life of this superwoman whose primary focus is attending to emergencies relating to children. While Jade’s “day job” involves kids, so does her “full-time job”. She is a mum to three small children, three teenage stepchildren and three fur-kids!
Source: Dr Jade Kua/Instagram
To add to all this busyness,
Jade also runs a
blog where she documents some of her experiences.
Jade enjoys the arts and writing so much that once upon a time she wanted to be a writer. Being a doctor, she views the healing process as not just a science, but as a form of art as well. Stemming from her atypical way of thinking, Jade is a huge advocate of alternative therapies such as art therapy and music therapy.
Managing a high-stress job like a boss
Source: Dr Jade Kua/Instagram
While being a paediatric emergency specialist is a high-stress job, Jade also finds the challenge of diagnosing the problem interesting. She has always been fascinated with frontline medicine as there is a fair amount of “sleuthing” that needs to be done when the patient is brought in. In a child’s case, they cannot even articulate what they are feeling most of the time. Hence, Jade is quite accustomed to staying focused amidst the screams of a young child in pain.
Jade says that being an emergency specialist is, “like putting together a puzzle based on what the patient complains about, and how they represent physically.” Investigations need to be done to deduce the the correct answers. Through it all, she takes special care to make the patient feel comfortable and confident that they are in good hands.
Jade points out that being in the emergency room at times could feel like a thankless job. She rarely gets the satisfaction of seeing her patient leaving the hospital, or on their way to recovery as the patient gets moved onto a ward after she has attended to them. However, she is quick to remind herself that feeling that way is okay and that this job isn’t about the rewards or merit.
She still DAREs to do more!
Source: Dr Jade Kua/Instagram
With everything she has on her plate, Jade still finds time to give back to the community in an important and impactful way.
Born out of many years of realising that the cardiac arrest survival rate is meagre in Singapore, in 2018,
Jade launched a
national campaign for her community initiative
DARE (Dispatcher Assisted First Responder) which has been five years in the making.
Through DARE, Jade aims to teach the general public how to do Cardiopulmonary resuscitation (CPR) and how to use an Automated External Defibrillator (AED). In addition to the launch of its nationwide campaign, DARE launched an app as well.
“This is a free app that anybody can download. We call it DARE because I feel that when it comes to training bystanders, I could give you a whole encyclopedia of medical facts. However even if you know in your head what needs to be done, and don’t dare to do it, nothing productive will come out of it.” Jade informs.
She also points out, “Statistics show that the cardiac arrest survival rate in Singapore is meagre. When I was working in the general emergency department, victims of cardiac arrest were brought in very late into the process of cell death. Once cells start dying, it would be challenging to revive them or save them.”
The great news is that the Singapore Ministry of Health is on board with DARE. The Ministry of Education has also stepped in by educating children in Singapore about DARE. Furthermore, the Singapore Civil Defence Force has come on board as a close working partner.
The DARE website and app have a thorough curriculum that is free to the public which includes motivational videos and 45-minute hands-on training session on how to perform CPR and use an AED. An AED is a smart computer that can read the rhythm of the heart, and that can indicate whether or not a shock is needed and if CPR needs to be continued. It does a new reading every two minutes.
Jade and her team have also spearheaded the installation of AEDs in many malls around Singapore and public places like the Singapore zoo. Every MOE school is equipped with three AEDs. In the next couple of years, the team plans to have them installed in many of the community centres and have one in every two Housing Development Board (HDB) blocks. Jade hopes to train at least one person in every household on how to do CPR.
A long road ahead
Source: Dr Jade Kua/Instagram
Having worked in the general emergency department, Jade knows how heart-wrenching it is to have to break bad news to the loved ones of patients. Jade says that many cardiac arrest-related deaths are to do with the downtime between the incident occurring and bringing the patient to the hospital.
This downtime can be reduced significantly if the patient receives CPR or if an AED is used. Every minute a person requires help but doesn’t get it means a 10% higher chance of dying. Furthermore, an ambulance takes an average time of 8 to 11 minutes to get to them.
“We realise that people don’t help because they don’t know what to do. They don’t recognise that a patient needs help and sometimes they don’t know whom to call. Many people don’t know that the emergency number is 995,” she emphasises.
Jade points out that in Singapore, we still don’t have a culture of giving way to ambulances and at times ambulances get stuck in traffic jams. When it finally arrives at the location— which most often is an HDB flat — there’s the challenge of getting the emergency team up to the patient. These are some of the reasons why there is usually a delay in help arriving at the patient’s side.
“And that results in a high death rate, and it’s not very good odds for the victim. After many years of this happening and wondering why people aren’t doing much, we decided to go out and do something about it,” explains Jade.
She continues adding that even if a person were to survive cardiac arrest or a stroke, the neurological outcome might be very dismal. She emphasises, “That’s why there are such high stakes on cardiac arrest, and I’ve devoted quite a lot of time and energy to this cause. It’s is also a community effort!”
Jade feels that another huge set back in getting cardiac arrest victims to help is the general public’s fear and insecurity in helping someone in need.
“You come up with all kinds of excuses why you don’t want to do it. Some don’t want to touch the opposite sex fearing they may get sued for molestation. Others point out that there’s no good samaritan law Singapore for helping a stranger.”
Jade focuses on looking past these potential challenges and soldering on. However, to address these challenges, she reminds us of these points:
Why more Singaporeans should DARE to help others
1. Remember that you are not alone. It is a community effort.
Jade informs that even if you haven’t attended a class, don’t have the app or aren’t CPR certified, you can still help. Moreover, it is essential that you do. You need to call the Singapore emergency number 995.
“The whole point is not to worry! All of this is a shared responsibility with the 995 specialists. The first step is to call 995. The 995 specialist or the dispatcher will walk you through the process while dispatching an ambulance. They assess the situation with you and will determine if CPR is needed,” Jade informs.
She clarifies, “The AEDs are meant for anybody to use, be it a child or a grown up. Anybody can read and look at the pictures and listen to the voice prompt. You don’t need to be certified to use it.”
However, Jade believes that attending a free DARE class or downloading the app does equip the general public with facts before an accident happens which is a confidence booster. “This cause is important enough for us as doctors to feel that the community needs information and the information should be freely available,” she says.
2. Don’t let the fear of “getting into trouble” hold you back
Addressing a fear that is on many people’s minds, Jade says that the Singapore penal code is strong enough to be able to protect you if you help someone. She adds, “Remember that this is a national effort and the Ministry of Law is well aware of all our efforts and that other ministries are involved as well. You don’t need to be afraid that you’re doing this alone. They’re all behind you and want you to help the poor victim.”
What about perceived molestation? “I’m a doctor, and I have been doing this for many years. Yes, I have cracked a rib before trying to perform CPR. Yes, I have I had to put my hands on a stranger. Sometimes a person is of a different gender, age or religious background. Nobody will find fault with you for saving his or her life,” shares Jade.
3. Reality isn’t what television portrays it to be!
Many are hesitant to touch a stranger let alone give them mouth-to-mouth ventilation. However, Jade points out that, “The general rule with CPR is that if you are a healthcare professional like me, you can perform chest compressions together with ventilation. However, if you are a general bystander, all you need to do is just chest compressions and use an AED. You don’t need to start ventilation for a grown-up victim. The paramedics will take over the ventilation when they arrive.”
4. Understand is that you are responsible for the fellow human beings around you.
Jade simply says, “The right thing to do if someone collapses is to come forward and help them rather than to be afraid that you will get into trouble!”
5. Let your children help!
“It seems that grown-ups feel hesitant to help more than children do. Many children are very eager to help because what they need to do has been taught to them in school. However, when they want to step up and help, their parents discourage them by saying that they could get into trouble for doing the wrong thing,” says Jade.
She continues, “This is why I wrote a children’s book because I want children to be familiar with the idea of helping people. A small child might not have the strength to perform CPR, but they can help with things like calling 995 and running to get the AED.”
The children’s book written by Jade is intended for grown-ups to read to their kids because, as a parent, she understood that parents need to support their kids’ enthusiasm to help.
Reflecting on what she has accomplished by launching DARE, Jade says, “I’m proud that we managed to launch this campaign. It took a long time, but the fact that we could raise funds and get ministries on board is a huge achievement to me.”
Continuing, she says, “I also think DARE is an important initiative that could change the mindset of Singaporeans. They can then help somebody who is in distress, which could lead to lesser fatalities. Another thing I’m very proud of is that we used to design and technology Innovations tools to help us in the very traditional art of healing, which is seldom done.”
Bringing our discussion to a close, Jade shares that this is a continuing journey for her. “It is not just about launching a campaign or an app. It is about following through and making sure it takes off, and people remember the key messages.”
Jade hopes that when the situation arises Singaporeans will offer help to people who need it and to continue to spread the message which is the hallmark of a truly successful campaign.
