Out of hospital cardiac arrests - the experience of one hospital in Singapore

In Singapore, all public emergency ambulances are equipped with semi-automa tic external defibrillators and the crew is trained in their use. This is t he first paper from Singapore reporting the survival rate in patients prese nting to an urban public hospital with acute coronary syndrome (ACS) who de veloped out-of-hospital cardiac arrest (OHCA). All consecutive patients who presented to the ED of a public hospital with OHCA or ACS were surveyed fr om 1 April 1999 to 30 September 1999. There were 392 patients among whom 11 5 (28.5%) had OHCA. There was no significant difference in age and gender d istribution between the OHCA and non-OHCA patients. More than 2/3 of the OH CA patients had no report of chest pain or breathlessness before they colla psed. Forty five (39.1%) of the 115 OHCA patients were noted to have initia l rhythms of ventricular tachycardia (VT) or ventricular fibrillation (VF) and received pre-hospital defibrillation. The mean time from collapse to fi rst DC shock was 12.07 +/- 7.2 min. Twenty (17.4%) of the OHCA patients had return of spontaneous circulation after resuscitation in the ED. Four pati ents (3.5%), all with an initial rhythm of VF were discharged alive from th e hospital. Much remains to be done to reduce the time interval to first DC shock for the OHCA group. (C) 2001 Elsevier Science Ireland Ltd. All right s reserved.