Sumitro Harjanto1, May Xue Bi Na2, Ying Hao3, Yih Yng Ng4, Nausheen Doctor5, E Shaun Goh6, Benjamin Sieu-Hon Leong7, Han Nee Gan8, Michael Yih Chong Chia9, Lai Peng Tham10, Si Oon Cheah11, Nur Shahidah5, Marcus Eng Hock Ong12. 1. Duke-NUS Medical School, Singapore, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 3. Division of Research, Singapore General Hospital, Singapore, Singapore. 4. Medical Department, Singapore Civil Defence Force, Singapore, Singapore. 5. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore. 6. Department of Acute and Emergency Care, Khoo Teck Puat Hospital, Singapore, Singapore. 7. Emergency Medicine Department, National University Hospital, Singapore, Singapore. 8. Accident & Emergency, Changi General Hospital, Singapore, Singapore. 9. Emergency Department, Tan Tock Seng Hospital, Singapore, Singapore. 10. Children's Emergency, KK Women's and Children's Hospital, Singapore, Singapore. 11. Emergency Medicine Department, Alexandra Hospital, Singapore, Singapore. 12. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore. Electronic address: marcus.ong.e.h@sgh.com.sg.
Abstract
AIM: To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. METHODS: This is an initial program evaluation of a national DACPR intervention. A before-after analysis was conducted using OHCA cases retrieved from a local registry and DACPR information derived from audio recordings and ambulance notes. The primary outcomes were survival to admission, survival at 30 days post-arrest and good functional recovery. RESULTS: Data was collected before the intervention (April 2010 to December 2011), during the run-in period (January 2012 to June 2012) and after the intervention (July 2012 to February 2013). A total of 2968 cases were included in the study with a mean age of 65.6. Overall survival rate was 3.9% (116) with good functional recovery in 2.2% (66) of the patients. BCPR rate increased from 22.4% to 42.1% (p<0.001) with odds ratio (OR) of 2.52 (95% confidence interval [CI]: 2.09-3.04) and ROSC increased significantly from 26.5% to 31.2% (p=0.02) with OR of 1.26 (95%CI: 1.04-1.53) after the intervention. Significantly higher survival at 30 days was observed for patients who received BCPR from a trained person as compared to no BCPR (p=0.001, OR=2.07 [95%CI: 1.41-3.02]) and DACPR (p=0.04, OR=0.30 [95%CI: 0.04-2.18]). CONCLUSION: A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.
AIM: To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. METHODS: This is an initial program evaluation of a national DACPR intervention. A before-after analysis was conducted using OHCA cases retrieved from a local registry and DACPR information derived from audio recordings and ambulance notes. The primary outcomes were survival to admission, survival at 30 days post-arrest and good functional recovery. RESULTS: Data was collected before the intervention (April 2010 to December 2011), during the run-in period (January 2012 to June 2012) and after the intervention (July 2012 to February 2013). A total of 2968 cases were included in the study with a mean age of 65.6. Overall survival rate was 3.9% (116) with good functional recovery in 2.2% (66) of the patients. BCPR rate increased from 22.4% to 42.1% (p<0.001) with odds ratio (OR) of 2.52 (95% confidence interval [CI]: 2.09-3.04) and ROSC increased significantly from 26.5% to 31.2% (p=0.02) with OR of 1.26 (95%CI: 1.04-1.53) after the intervention. Significantly higher survival at 30 days was observed for patients who received BCPR from a trained person as compared to no BCPR (p=0.001, OR=2.07 [95%CI: 1.41-3.02]) and DACPR (p=0.04, OR=0.30 [95%CI: 0.04-2.18]). CONCLUSION: A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.
Authors: Chi Keong Ching; Siew Hon Benjamin Leong; Siang Jin Terrance Chua; Swee Han Lim; Kenneth Heng; Sohil Pothiawala; Venkataraman Anantharaman Journal: Singapore Med J Date: 2017-07 Impact factor: 1.858
Authors: Nausheen Edwin Doctor; Nur Shahidah Binte Ahmad; Pin Pin Pek; Susan Yap; Marcus Eng Hock Ong Journal: Singapore Med J Date: 2017-07 Impact factor: 1.858
Authors: Alexander E White; Andrew Fw Ho; Nur Shahidah; Nurul Asyikin; Le Xuan Liew; Pin Pin Pek; Jade Ph Kua; Michael Yc Chia; Yih Yng Ng; Shalini Arulanandam; Sieu-Hon Benjamin Leong; Marcus Eh Ong Journal: Singapore Med J Date: 2021-08 Impact factor: 1.858