Objective To describe the outcomes of patients with out‐of‐hospital cardiac arrest (OHCA) transported to hospital in Hanoi, Vietnam. Methods This was a multi‐centre observational study of patients presenting with OHCA to one of five tertiary care hospital EDs in Hanoi from 2017 to 2019. Results We analysed data from 239 OHCA cases of which 70.7% were witnessed, and 8.4% received bystander cardiopulmonary resuscitation (CPR). The emergency medical services (EMS) transported 20.5% of cases to hospital with the remaining being transported by private vehicle. No patients received external defibrillation before arriving to hospital. Return of spontaneous circulation in hospital was 33.1%, with 3.8% of patients survived to hospital discharge and only one patient (0.4%) discharged from hospital with a favourable neurological outcome. Conclusions In cases of OHCA in Hanoi, both the proportion of cases receiving bystander CPR and EMS transportation were small. Urgent investments in pre‐hospital capacity, training and capabilities are required to improve outcomes for OHCA in Hanoi.

Aim: The aim of this study was to determine why bystanders did not use formal Emergency Medical Services (EMS) or conduct cardiopulmonary resuscitation (CPR) on the scene for out-of-hospital cardiac arrest (OHCA) patients in Hanoi, Vietnam. Methods: This was a prospective, observational study of OHCA patients admitted to five tertiary hospitals in the Hanoi area from June 2018 through January 2019. The data were collected through interviews (using a structured questionnaire) with bystanders. Results: Of the 101 patients, 79% were aged <65 years, 71% were men, 79% were witnessed to collapse, 36% were transported to the hospital by formal EMS, and 16% received bystander CPR at the scene. The most frequently indicated reason for not using EMS by the attendants was “using a private vehicle or taxi is faster” (85%). The reasons bystanders did not conduct CPR at the scene included “not recognizing the ailment as cardiac arrest” (60%), “not knowing how to perform CPR” (33%), and “being afraid of doing harm to patients” (7%). Only seven percent of the bystanders had been trained in CPR. Conclusion: The information revealed in this study provides useful information to indicate what to do to increase EMS use and CPR provision. Spreading awareness and training among community members regarding EMS roles, recognition of cardiac arrest, CPR skills, and dispatcher training to assist bystanders are crucial to improve the outcomes of OHCA patients in Vietnam.

Acute myocarditis is one of the common complications of coronavirus disease 2019 (COVID-19) with a relatively high case fatality. Here reported is a fulminant case of a 42-year-old previously healthy woman with cardiogenic shock and refractory cardiac arrest due to COVID-19-induced myocarditis who received veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after 120 minutes of cardiopulmonary resuscitation (CPR). This is the first adult case of cardiac arrest due to COVID-19-induced myocarditis supported by ECMO that fully recovered with normal neurological functions. The success of the treatment course with full recovery emphasized the potential role of ECMO in treating these patients.

Controversy persists regarding the safety and efficacy of an accelerated low-dose recombinant tissue-type plasminogen activator (rt-PA) regimen for reperfusion therapy in acute pulmonary embolism. This study describes the outcomes of an accelerated low-dose rt-PA regimen for the treatment of acute pulmonary embolism in Vietnamese patients. This was a case series from October 2014 to October 2020 from 9 hospitals across Vietnam. Patients presenting with acute pulmonary embolism with high to intermediate mortality risk were administered alteplase 0.6 mg per kilogram (maximum of 50 mg) over 15 min. The main outcomes were the proportion who survived to hospital discharge and at 3 months as well as in-hospital hemorrhage (major and minor according to International Society of Thrombosis and Hemhorrage definitions). A total of 80 patients were enrolled: 48 (60%) with high risk for mortality and 32 patients (40%) with intermediate risk for mortality. A total of 7 (8.8%) died in hospital. All deaths occurred in the high-risk mortality group. The 73 patients who were discharged alive remained alive at 3 months follow up. During hospitalization, 1 patient (1.3%) suffered major bleeding, and 7 (8.8%) had minor bleeding. An accelerated thrombolytic regimen with alteplase 0.6 mg/kg (maximum of 50 mg) over 15 min for acute pulmonary embolism appeared be effective and safe in a case series of Vietnamese patients.