title: Is public access defibrillation needed in Hong Kong?
abstract: The survival rate for non-traumatic out-of-hospital cardiac arrest in Hong Kong is low (1.25%-1.6%). Despite the reduced time interval between call receipt and first defibrillatory shock to 11.12 minutes during the past decade, the time interval between collapse/recognition and first defibrillatory shock, at 14.25 minutes, is too long. Studies of out-of-hospital cardiac arrest performed in Hong Kong were reviewed to ascertain whether a public access defibrillation programme can improve survival in Hong Kong. Three delays were found in the traditional response by emergency medical service, namely in the collapse/recognise-to-call receipt, call receipt-to-vehicle stops, and vehicle stops-to-first defibrillatory shock time intervals. The first delay is related to public education, while the second and third delays are intrinsic to a dispatched response. A public access defibrillation programme employing responders at scenes of cardiac arrests can eliminate the collapse/recognise-to-call receipt and call receipt-to-vehicle stops time intervals before defibrillation. Possible sites of public access defibrillation could include the airport and other immigration points, which have a high volume of people passing through, with projected figures for out-of-hospital cardiac arrest at these sites supporting this consideration. For successful implementation of public access defibrillation, a comprehensive educational programme and coordination with the emergency medical service are required.
authors.affiliation: Accident and Emergency Department, North District Hospital, 9 Po Kin Road, Sheung Shui, Hong Kong.
authors.forename: C B
authors.initials: CB
authors.lastname: Lo
authors.forename: T W
authors.initials: TW
authors.lastname: Wong
authors.forename: K K
authors.initials: KK
authors.lastname: Lai
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D004554:Electric Countershock / Q000295:instrumentation*; D004632:Emergency Medical Services; D004638:Emergency Treatment; D006297:Health Services Accessibility; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006723:Hong Kong; D006801:Humans; D016019:Survival Analysis