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Review
. 2021 Aug;62(8):438-443.
doi: 10.11622/smedj.2021114.

An essential review of Singapore's response to out-of-hospital cardiac arrests: improvements over a ten-year period

Alexander E White  1   2 , Andrew Fw Ho  2   3 , Nur Shahidah  3 , Nurul Asyikin  1 , Le Xuan Liew  1 , Pin Pin Pek  2   3 , Jade Ph Kua  4 , Michael Yc Chia  5 , Yih Yng Ng  5   6 , Shalini Arulanandam  7 , Sieu-Hon Benjamin Leong  8 , Marcus Eh Ong  3   9
Affiliations
Review

An essential review of Singapore's response to out-of-hospital cardiac arrests: improvements over a ten-year period

Alexander E White et al. Singapore Med J. 2021 Aug.

Abstract

Care for patients who experience out-of-hospital cardiac arrest (OHCA) has rapidly evolved in the past decade. Increased sophistication of care in the community, emergency medical services (EMS) and hospital setting is associated with improved patient-centred outcomes. Notably, Utstein survival doubled from 11.6% to 23.1% between 2011 and 2016. These achievements involved collaboration between policymakers, clinicians and researchers, and were made possible by a strategic interplay of policy, research and implementation. We review the development and current state of OHCA in Singapore using primary population-based data from the Pan-Asian Resuscitation Outcomes Study and an unstructured search of research databases. We discuss the roles of important milestones in policy, community, dispatch, EMS and hospital interventions. Finally, we relate these interventions to relevant processes and outcomes, such as the relationship between the strategic implementation of bystander cardiopulmonary resuscitation and placement of automated external defibrillator with return of spontaneous circulation, survival to discharge and survival with favourable neurological outcomes.

Keywords: CPR+AED; dispatchers; feedback; out-of-hospital cardiac arrest; smartphone applications.

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Figures

Fig. 1
Fig. 1
Chart shows the timeline of key prehospital initiatives. CPR: cardiopulmonary resuscitation; CRN: clinical research network; PAROS CRN: Pan-Asian Resuscitation Outcomes Study Clinical Research Network
See this image and copyright information in PMC

References

    1. Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates:systematic review of 67 prospective studies. Resuscitation. 2010;81:1479–87. - PubMed
    1. Kiguchi T, Okubo M, Nishiyama C, et al. Out-of-hospital cardiac arrest across the world:first report from the International Liaison Committee on Resuscitation (ILCOR) Resuscitation. 2020;152:39–49. - PubMed
    1. Lai H, Choong CV, Fook-Chong S, et al. Interventional strategies associated with improvements in survival for out-of-hospital cardiac arrests in Singapore over 10 years. Resuscitation. 2015;89:155–61. - PubMed
    1. White AE, Poh JS, Pek PP, et al. Singapore out-of-hospital cardiac arrest registry report 2011-2018. Unit for Pre-hospital Emergency Care, Singapore. [Accessed August 3, 2021]. Available at: https://www.myheart.org.sg/wp-content/uploads/2021/01/Singapore-OHCA-Dat... .
    1. Ong MEH, Chan YH, Anantharaman V, et al. Cardiac arrest and resuscitation epidemiology in Singapore (CARE I Study) Prehosp Emerg Care. 2003;7:427–33. - PubMed