Outcomes for out‐of‐hospital cardiac arrest transported to emergency departments in Hanoi, Vietnam: A multi‐centre observational study

Abstract

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.

Why Bystanders Did Not Perform Cardiopulmonary Resuscitation on Out-of-Hospital Cardiac Arrest Patients: A Multi-Center Study in Hanoi (Vietnam)

“…Out-of-hospital cardiac arrest (OHCA) is a global health challenge with large regional variations in incidence and patient prognosis: the incidence ranges 50-110 per 100,000 people per year 1 and the proportion of patients' survival-to-discharge ranges from nearly 0.0% to 16.2%. [2][3][4][5][6] Particularly, low-and middle-income countries with undeveloped Emergency Medical Service (EMS) systems have shown poor patient prognoses. [2][3][4][5][6] Improving the outcomes of OHCA patients requires a rapid reaction chain including bystanders, EMS, and hospitals.…”

“…[2][3][4][5][6] Particularly, low-and middle-income countries with undeveloped Emergency Medical Service (EMS) systems have shown poor patient prognoses. [2][3][4][5][6] Improving the outcomes of OHCA patients requires a rapid reaction chain including bystanders, EMS, and hospitals. 7 Of these, the importance of bystander cardiopulmonary resuscitation (CPR) and of the EMS dispatcher role in facilitating and instructing bystander CPR is vital.…”

“…5,10,11 Particularly in regions with undeveloped EMS systems, severely ill or injured patients are often brought to the hospital by non-EMS vehicles. [2][3][4]12 These situations obviously aggravate the prognoses of patients in low-and middle-income countries.…”

“…8,9 However, in communities with low EMS use, found mostly in low-and middle-income countries, dispatcher assistance is unlikely to reach the bystanders. [2][3][4]12 The reasons people do not use EMS in a critical condition such as OHCA have rarely been investigated as countries with functioning EMS do not encounter this issue.…”

Survival after traumatic out-of-hospital cardiac arrest in Vietnam: a multicenter prospective cohort study

“…The Government of Vietnam introduced a nationwide policy on the EMS system in 2008, however, pre-hospital services are not well developed and only a few places, such as urban areas, have a functioning EMS system. Additionally, the lack of a trauma system of care prevents integration of pre-hospital and hospital treatment protocols and the collection of clinical data for surveillance, quality improvement and research related activities [ 21 , 25 – 28 ]. Moreover, the ambulances, trained and accredited medical staff, and life-saving equipment available are limited, and medical oversight and regular monitoring of quality indicators are uncommon [ 27 , 29 ].…”