Is public access defibrillation needed in Hong Kong?

Area of Science:

• Emergency Medicine
• Public Health
• Cardiology

Background:

• Survival rates for non-traumatic out-of-hospital cardiac arrest (OHCA) in Hong Kong are critically low, ranging from 1.25% to 1.6%.
• Despite improvements in emergency medical service (EMS) response, the time from collapse recognition to defibrillation remains prolonged at 14.25 minutes.

Purpose of the Study:

• To evaluate the potential of a public access defibrillation (PAD) program to enhance OHCA survival rates in Hong Kong.
• To identify and analyze delays within the traditional EMS response pathway for OHCA.

Main Methods:

• Review of existing studies on out-of-hospital cardiac arrest in Hong Kong.
• Analysis of time intervals: collapse/recognition to call receipt, call receipt to vehicle arrival, and vehicle arrival to first defibrillatory shock.
• Assessment of PAD program's potential to mitigate pre-hospital delays.

Main Results:

• Significant delays identified in the EMS response: public education (collapse/recognition to call receipt) and dispatch logistics (call receipt to defibrillation).
• PAD programs utilizing lay responders can potentially eliminate the initial collapse recognition and call receipt delays.
• High-traffic public locations like airports are suitable sites for PAD implementation due to projected OHCA incidence.

Conclusions:

• A public access defibrillation program offers a viable strategy to improve OHCA survival in Hong Kong by reducing critical response times.
• Successful PAD implementation necessitates a robust public education strategy and seamless coordination with existing emergency medical services.
• Targeted PAD deployment in high-risk, high-traffic areas can significantly impact immediate resuscitation efforts.