Out-of-hospital cardiac arrest in Hong Kong.
OBJECTIVE
To evaluate the effectiveness of the local emergency medical services system in resuscitation of out-of-hospital cardiac arrest and identify areas for improvement.


METHODS
This was a prospective descriptive study of adults with nontraumatic out-of-hospital cardiac arrest treated in the three accident & emergency departments that serve the whole of Hong Kong Island from March 15, 1999, to October 15, 1999. Patient characteristics, circumstances of cardiac arrest, final outcomes, and response times of the ambulance service were recorded according to the Utstein style.


RESULTS
Three hundred twenty patients were included. There was male predominance, and the mean age was 71.5 years. The majority of cardiac arrests occurred at patients' homes. In 57.5% of cases the arrest was not witnessed. The bystander cardiopulmonary resuscitation (CPR) rate was 15.6%. The most common electrocardiographic (ECG) rhythm at scene was asystole. Ventricular fibrillation or pulseless ventricular tachycardia constituted 14.1%. The average call to dispatch interval was 1.04 minutes. The average call to CPR interval was 9.82 minutes. The average total prehospital interval was 27.55 minutes. The overall immediate survival rate was 14.1% and the rate of survival to hospital discharge was 1.25%.


CONCLUSIONS
The prognosis of out-of-hospital cardiac arrest in Hong Kong was dismal. Every link in the chain of survival has to be improved.
Leung
L P
LP
Accident & Emergency Department, Queen Mary Hospital, Pokfulam, Hong Kong. lpleung@yahoo.co.uk
Wong
T W
TW
Tong
H K
HK
Lo
C B
CB
Kan
P G
PG
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D004554:Electric Countershock / Q000706:statistics & numerical data; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D005392:First Aid / Q000706:statistics & numerical data; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011787:Quality of Health Care; D015996:Survival Rate; D013996:Time and Motion Studies