Characteristics of out of hospital cardiac arrest in the United Arab Emirates

Abstract

Background:Out of hospital cardiac arrest is one of the leading causes of death globally. This study aimed to identify the characteristics of out of hospital cardiac arrest patients who were attended and treated by the National Ambulance crew. A lot of studies reported the importance of implementing chain of survival to increase survival rates from cardiac arrest. To be implemented in United Arab Emirates (UAE), it required a detailed study of the community engagement. The study aimed to explore the demography of the incidences, location, age, gender epidemiology of the patients who had their cardiac arrest witnessed along with their Bystander cardiopulmonary resuscitation (CPR) performed prior to the arrival of National Ambulance and public access to an automated external defibrillator. The return of spontaneous circulation was also explored prior to their arrival to the emergency department.Methods:The research is a prospective descriptive cohort study of out of hospital cardiac arrest patients attended by National Ambulance between July 2017 and June 2018. The National Ambulance provides emergency medical services for public and private hospitals in the Emirates of Sharjah, Ajman, Ras-al-Khaimah, Fujairah, and Umm Al-Quwain and its clients in Abu Dhabi in UAE. Data for the study were collected by the National Ambulance crew attending the OHCA patients, using a structured questionnaire.Results:In this 1-year period, a total of 715 out of hospital cardiac arrest cases were attended by the National Ambulance with higher percentage (77%) of male patients. Resuscitation and transportation were attempted for 95% whereas 5% were pronounced dead on the spot. In this study, the median age of the patients was 50 years. Majority of the patients were Asians 55% (n = 395) followed by Arabs non-UAE citizens 19.4% (n = 139) and UAE citizens 16% (n = 113). Patients facing sudden cardiac arrest in their homes or residences represented 69.9% (n = 500), street and public places 22.5% (n = 161), and workplace 6.8% (n = 49). The percentage of patients who had witnessed cardiac arrest was 51.7% (n = 370) only 197 had CPR performed on them prior to the arrival of National Ambulance. Low public access to AED was found in this population that is 1.8% (n = 13). A majority of the participants in this study had nonshockable rhythms 84.3% (n = 603) whereas shockable rhythms presented on 11% (n = 80). The percentage of patients who had ROSC at the scene or en route to the hospitals was found 9.2% (n = 66).Conclusion:In this 1-year study, the result showed that cardiac arrest was recognized and witnessed in about half of the cases, but low bystander CPR was performed. Low public access and use of AED were found. Data on hospitalized and discharged OHCA patients were not available and required further linkage and corporation between ambulance services and hospitals to ensure data continuity of OHCA cases. This study is essential for the implementation of proper chain of survival and reduction in mortality rates in UAE.

176. Out-of-hospital cardiac arrests in the Gulf region: a scoping review

“…A number of studies in our review reported high rates of cardiac risk factors including diabetes mellitus, hypertension, hyperlipidaemia, chronic renal failure, and acute coronary syndrome (18,19,23,24,26,28,34). Additionally, the high rate of expatriate populations living in some GCC countries (17,19,22), and their unique lifestyle risk factors (such as high rates of smoking) may have contributed to the observed young age and male dominance of OHCA cases in our review. We also observed differences in OHCA demographics in these populations compared to the national populations.…”

“…For example, compared to GCC national patients, South Asian and North African patients were more likely to smoke, but had lower levels of comorbidities (18,23). Despite this, South Asian and North African patients were generally younger, and accounted for a large percentage of total OHCA cases in a number of studies (17,19,22), possibly attributable to population demographics. Data on specific process .…”

Out-of-hospital cardiac arrest in countries of the Gulf Cooperation Council: a scoping review

“…For example, compared to GCC national patients, South Asian and North African patients were more likely to smoke, but had lower levels of comorbidities (18,23). Despite this, South Asian and North African patients were generally younger, and accounted for a large percentage of total OHCA cases in a number of studies (17,19,22), possibly attributable to population demographics. Data on specific process and outcome findings for national populations was not well reported across the studies.…”

“…We also observed over-reliance on private transport rather than EMS to transport OHCA patients, mirroring results in non-OHCA studies in the region (38). Attempts to address such challenges are yielding results, as evidenced in the reported increased use of EMS for OHCA (17,19,20); however, public perceptions related to recognising and intervening in OHCA remain unstudied in the GCC.…”

Use of Public Automated External Defibrillators in Out-of-Hospital Cardiac Arrest in Poland

“…SCA can occur in any location. Out-of-hospital cardiac arrest (OHCA) according to Engdahl et al most commonly occurs at home, which is confirmed by Alqahtani et al adding the street and public places and the workplace [ 3 , 4 ]. The frequency of OHCA episodes varies widely around the world (higher in North American countries than in Europe, Asia, or Australia).…”