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Fulltext A Double-Blind, Randomized Control Trial of Rapidly Infused High Strong Ion Difference (SID) Fluid Versus Hartmann's Solution on Acid-Base Status in Sepsis Patients in the Emergency Department

Yeoh C, Teo A, Azhar AMN, Suann ST, Thum Y, Wong KD, et al.

J Acute Med, 2019 Sep 01;9(3):128-144.
PMID: 32995241 DOI: 10.6705/j.jacme.201909_9(3).0005

Background: Balanced fluids are preferred in initial resuscitation of septic patients based on several recent studies. The Stewart's concept on acid-base balance predicts that high strong ion difference (SID) fluid thus will increase the pH level. To date, the impact of high SID fluid in septic patient with metabolic acidosis remains uncertain. We conducted single center, randomized, double-blind trial to compare the effect of high SID fluid vs. Hartmann's solution on acid-base status in selected sepsis patients in the Emergency Department.
Methods: Septic patient with hyperlactatemia and metabolic acidosis were randomized to receive either high SID fl uid or Hartmann's solution during initial fl uid resuscitation. The primary outcome measures the pH and bicarbonate levels difference pre- and post- resuscitation.
Results: One hundred and sixty-two patients underwent randomization, 81 were assigned each to receive high SID fluid or Hartmann's solution. Both groups had similar baseline characteristics. High SID group received 23.5 mL/kg and the Hartmann's group received 22.7 mL/kg (p = 0.360). High SID fluid increased the mean (± SD) pH by 0.107 (± 0.09) vs. Hartmann's solution by 0.014 (± 0.12), p ≤ 0.001. Mean bicarbonate level increased signifi cantly in high SID group compared to Hartmann's (4.30 ± 3.76 vs. 1.25 ± 3.33, p ≤ 0.001). High SID group had higher post resuscitation lactate clearance than Hartmann's group (25.4 ± 28.3% vs. 12.0 ± 34.1%, p = 0.009). Shorter hospital stay was observed in highSID group 8.04 ± 5.96 days vs. Hartmann's group 12.18 ± 12.41 days (p = 0.048). Both groups showed no difference in incidence of pulmonary oedema, acute kidney injury and mortality.
Conclusions: Initial resuscitation using high SID fluid in selected septic patient improves pH and bicarbonate levels. The high SID group had better post resuscitation lactate clearance and shorter hospital stay.

Matched MeSH terms: Resuscitation
Fulltext A Study of House Officers in a Teaching Hospital on Knowledge, Perception of Skills and Confidence Level in

Ismail Mohd Saiboon, Noraliza Mohd Ariffin, Teodoro Javier Herbosa, Ahmad Khaldun Ismail, Nariman Singmamae, Shamsuriani Md Jamal, et al.

Medicine & Health, 2007;2(2):110-116.
MyJurnal

Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these doctors are usually the first to attend. Therefore an HO must be confident with CPR skills. They must be competent in performing CPR. The authors assessed 26 new HOs from Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception about CPR skills, confidence level in performing CPR and knowledge in performing CPR. Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed themselves to have inadequate knowledge and 46.2% had no confidence in performing CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal paddle and cardiac apex paddle positions correctly placed respectively. In conclusion, knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and need further assessment and improvement. Medical schools need to review their CPR curriculum in order to prepare HOs adequately to work in emergency situations.

Matched MeSH terms: Cardiopulmonary Resuscitation
Fulltext A Survey on The Knowledge, Attitude and Confidence Level of Adult Cardiopulmonary Resuscitation Among Junior Doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia

Chew F Z A W M N KS, Mohd Hashairi F, Ida Zarina Z, Shaik Farid AW, Abu Yazid MN, Nik Hisamuddin NA

Med J Malaysia, 2011 Mar;66(1):56-9.
PMID: 23765145 MyJurnal

Junior doctors are often the "first line" doctors called to attend to patients in cardiac arrest. We performed an anonymous questionnaire study from October 2008 to December 2008 to assess the knowledge, attitude and skill of cardiopulmonary resuscitation among junior doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. Out of the 100 questionnaire forms sent out, 70 were returned completed. The majority (85.8%) stated that they were not confident of managing a resuscitation case. There was a statistically significant (p<0.001) association between duration of clinical practice and confidence level. Up to 77.1% said that BLS should be re-certified every two years.

Matched MeSH terms: Cardiopulmonary Resuscitation*
Fulltext A case of cardiac arrest due to air embolism during scoliosis surgery

Haji Mohd Amin MZ, Beng JTB, Young BTY, Faruk Seman NA, Ching TS, Chek WC

J Orthop Surg (Hong Kong), 2019 4 9;27(2):2309499019840083.
PMID: 30955449 DOI: 10.1177/2309499019840083

Cardiac arrest during scoliosis surgery is rare in idiopathic scoliosis. We present a case of cardiorespiratory collapse during corrective surgery in a young patient with idiopathic scoliosis. A diagnosis of venous air embolism was made by exclusion. A cardiorespiratory resuscitation was performed in supine position. Patient recovered without any sequelae and had operation completed 6 weeks later.

Matched MeSH terms: Cardiopulmonary Resuscitation/methods
Fulltext A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

Sheng CK, Lim CK, Rashidi A

Int J Emerg Med, 2010;3(4):287-91.
PMID: 21373294 DOI: 10.1007/s12245-010-0218-4

The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied.

Matched MeSH terms: Resuscitation
Fulltext A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia

Rahman NH, Keng Sheng C, Kamauzaman TH, Md Noh AY, Wahab SF, Zaini IZ, et al.

Int J Emerg Med, 2013;6(1):37.
PMID: 24135122 DOI: 10.1186/1865-1380-6-37

We performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia.

Matched MeSH terms: Cardiopulmonary Resuscitation
A novel approach to life support training using "action-linked phrases"

Hunt EA, Cruz-Eng H, Bradshaw JH, Hodge M, Bortner T, Mulvey CL, et al.

Resuscitation, 2015 Jan;86:1-5.
PMID: 25457379 DOI: 10.1016/j.resuscitation.2014.10.007

Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy.

Matched MeSH terms: Cardiopulmonary Resuscitation/education*
Fulltext A study assessing the impact of different teaching modalities for pharmacy students in a Cardio-Pulmonary Resuscitation (CPR) course

Khan TM, Hassali MA, Rasool ST

Saudi Pharm J, 2013 Oct;21(4):375-8.
PMID: 24227957 DOI: 10.1016/j.jsps.2012.11.002

The current study aims to assess the effectiveness of different teaching methods adopted for the practical session of Cardio-Pulmonary Resuscitation (CPR). CPR training is one of the compulsory modules of the Public Health Pharmacy (PHP) course at Universiti Sains Malaysia. CPR training comprises of 10% of total marks of the PHP course. To test the effectiveness of the different teaching strategies, three groups were defined using a two-stage cohort distribution-i.e. based on grade point average (GPA) and different teaching modalities. Group One was instructed using images and PowerPoint lecture slides. Group Two was instructed using videos and PowerPoint lecture slides. Group Three was instructed using PowerPoint slides with white boards and videos. Students in Group Three were not provided with a hard/soft copy of the PowerPoint slides and were encouraged to write down all the information on their personal notebooks. A 20-item questionnaire was used to assess the students' understanding toward the CPR session. Data were analyzed using the Statistical Package for Social Science Students, SPSS version 13®. Based on the response attained, the comparison of the final score among the groups was undertaken using one way ANOVA. Twenty-seven students have participated in this study. Final evaluation using the questionnaire revealed that student's in Group Three had a better understanding of CPR (18.1 ± 1.5, p <0.001) than the other two. Students' note taking during the lecture and use of traditional chalkboard teaching were found significant to improve the students' understanding and learning in the CPR session.

Matched MeSH terms: Cardiopulmonary Resuscitation
Fulltext A unique case of tetrodotoxin poisoning

Loke YK, Tan MH

Med J Malaysia, 1997 Jun;52(2):172-4.
PMID: 10968077

A 69-year-old lady who was referred by her general practitioner with a diagnosis of food poisoning developed cardiorespiratory arrest shortly after arriving at the Casualty Department. Cardiac output was successfully restored with resuscitation but she had to be mechanically ventilated due to the absence of any spontaneous respiratory effort. Assessment 24 hours after admission, showed fixed and dilated pupils with brain stem areflexia. Her family was told that the prognosis was hopeless. Surprisingly, her condition rapidly improved a day later and she eventually had a good recovery. Her condition was actually due to severe tetrodotoxin poisoning after eating roe of the puffer fish and it was fortunate that appropriate aggressive resuscitation was instituted to revive the patient from her critical state.

Matched MeSH terms: Resuscitation
Fulltext Active resuscitation in Malaysian district hospitals--is it adequate?

Chan SC

Med J Malaysia, 1997 Sep;52(3):244-50.
PMID: 10968093

Adequacy of active resuscitation in collapsed inpatients aged 12 and above (excluding those with terminal illness) were studied in 6 Malaysian district hospitals for 3 months starting 1/1/93. Results showed 59.5% (25 out of 42 inpatients) were inadequately resuscitated measured by: failure of nurses to initiate resuscitation (24%), duration of resuscitation less than 30 minutes (42%) and incompletely equipped emergency trolleys (44%). Questionnaires revealed lack of knowledge and training in cardiopulmonary resuscitation in medical staff. Regular cardiopulmonary resuscitation courses, regular spot checks on emergency trolleys and management protocols on active resuscitation are recommended. Each hospital should design its own criteria for adequacy.

Matched MeSH terms: Cardiopulmonary Resuscitation/standards*
Association of the Emergency Medical Services-Related Time Interval with Survival Outcomes of Out-of-Hospital Cardiac Arrest Cases in Four Asian Metropolitan Cities Using the Scoop-and-Run Emergency Medical Services Model

Kim TH, Lee K, Shin SD, Ro YS, Tanaka H, Yap S, et al.

J Emerg Med, 2017 Nov;53(5):688-696.e1.
PMID: 29128033 DOI: 10.1016/j.jemermed.2017.08.076

BACKGROUND: Response time interval (RTI) and scene time interval (STI) are key time variables in the out-of-hospital cardiac arrest (OHCA) cases treated and transported via emergency medical services (EMS).
OBJECTIVE: We evaluated distribution and interactive association of RTI and STI with survival outcomes of OHCA in four Asian metropolitan cities.
METHODS: An OHCA cohort from Pan-Asian Resuscitation Outcome Study (PAROS) conducted between January 2009 and December 2011 was analyzed. Adult EMS-treated cardiac arrests with presumed cardiac origin were included. A multivariable logistic regression model with an interaction term was used to evaluate the effect of STI according to different RTI categories on survival outcomes. Risk-adjusted predicted rates of survival outcomes were calculated and compared with observed rate.
RESULTS: A total of 16,974 OHCA cases were analyzed after serial exclusion. Median RTI was 6.0 min (interquartile range [IQR] 5.0-8.0 min) and median STI was 12.0 min (IQR 8.0-16.1). The prolonged STI in the longest RTI group was associated with a lower rate of survival to discharge or of survival 30 days after arrest (adjusted odds ratio [aOR] 0.59; 95% confidence interval [CI] 0.42-0.81), as well as a poorer neurologic outcome (aOR 0.63; 95% CI 0.41-0.97) without an increasing chance of prehospital return of spontaneous circulation (aOR 1.12; 95% CI 0.88-1.45).
CONCLUSIONS: Prolonged STI in OHCA with a delayed response time had a negative association with survival outcomes in four Asian metropolitan cities using the scoop-and-run EMS model. Establishing an optimal STI based on the response time could be considered.

Matched MeSH terms: Cardiopulmonary Resuscitation/methods; Cardiopulmonary Resuscitation/standards
Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients

Ng YY, Wah W, Liu N, Zhou SA, Ho AF, Pek PP, et al.

Resuscitation, 2016 May;102:116-21.
PMID: 26970031 DOI: 10.1016/j.resuscitation.2016.03.002

BACKGROUND: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies.
OBJECTIVES: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population.
METHODOLOGY: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge.
RESULTS: We included a total of 40,159 OHCA cases, 40% of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment.
CONCLUSION: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.
KEYWORDS: Gender; Out-of-hospital cardiac arrest; Registry

Matched MeSH terms: Cardiopulmonary Resuscitation
Fulltext Attitudes and perceptions of the general Malaysian public regarding family presence during resuscitation

Chew KS, Ghani ZA

Singapore Med J, 2014 Aug;55(8):439-42.
PMID: 25189307

INTRODUCTION: Family presence (FP) during resuscitation is an increasingly favoured trend, as it affords many benefits to the critically ill patient's family members. However, a previously conducted study showed that only 15.8% of surveyed Malaysian healthcare staff supported FP during resuscitation.

METHODS: This cross-sectional study used a bilingual self-administered questionnaire to examine the attitudes and perceptions of the general Malaysian public toward the presence of family members during resuscitation of their loved ones. The questionnaires were randomly distributed to Malaysians in three different states and in the federal territory of Kuala Lumpur.

RESULTS: Out of a total of 190 survey forms distributed, 184 responses were included for analysis. Of the 184 respondents, 140 (76.1%) indicated that they favoured FP during resuscitation. The most common reason cited was that FP during resuscitation provides family members with the assurance that everything possible had been done for their loved ones (n = 157, 85.3%). Respondents who had terminal illnesses were more likely to favour FP during resuscitation than those who did not, and this was statistically significant (95.0% vs. 73.8%; p = 0.04).

CONCLUSION: FP during resuscitation was favoured by a higher percentage of the general Malaysian public as compared to Malaysian healthcare staff. This could be due to differences in concerns regarding the resuscitation process between members of the public and healthcare staff.

Matched MeSH terms: Resuscitation/methods*
Fulltext Blunt injuries to the liver: problems and management

Balasegaram M

Ann Surg, 1969 Apr;169(4):544-50.
PMID: 5774743

Thirty-five patients with blunt hepatic injuries treated in a 7-year period are reviewed. The difficulties of diagnosis are stressed in that only 48.6%c were diagnosed
preoperatively. Associated intra-abdominal and concomitant head, chest, pelvic and skeletal injuries accounted for most of these difficulties. Seventeen of the 35 patients had extensive lacerations or intra-lobar ruptures of the liver. Simple linear or stellate lacerated wounds were treated by drainage, or suture, or debridement of the ragged liver edges and suture. Prior to 1964 extensively lacerated liver wounds were treated by gauze packing. Three (60%c) of five patients thus treated died, while the others had multiple complications. Since 1964, packing has been abandoned in favor of major resection and of 11 patients who underwent such procedures only one died. Hepatic resection for severe blunt injuries has the advantages of removal of all devitalized liver, control of hemorrhage, reduction of postoperative complications such as secondary hemorrhage, intraabdominal and hepatic abscesses and hemobilia. Hepatic resection is recommended for subeapsular hematomas with intra-lobar rupture of the liver to avoid hepatic necrosis. These injuries are diagnosed by injection of methylene blue into the common hepatic duct. Low mortality and morbidity in this series is due to improved care of injured pa-tients, early surgical intervention and adequate removal of devitalized lacerated and injured tissues by debridement or major hepatic resection.

Matched MeSH terms: Resuscitation
Fulltext Cardiopulmonary resuscitation : the short comings in Malaysia

Sheng CK, Zakaria MI, Rahman NH, Jaalam K, Adnan WA

Malays J Med Sci, 2008 Jan;15(1):49-51.
PMID: 22589616

This short review explores the current status of cardiopulmonary resuscitation in Malaysia and highlights some of the factors that have a negative impact on its rate of success. Absence of a unifying body such as a national resuscitation council results in non-uniformity in the practice and teaching of cardiopulmonary resuscitation. In the out-of-hospital setting, there is the lack of basic skills and knowledge in performing bystander cardiopulmonary resuscitation as well as using an automated external defibrillator among the Malaysian public. The ambulance response time is also a significant negative factor. In the in-hospital setting, often times, resuscitation is first attended by junior doctors or nurses lacking in the skill and experience needed. Resuscitation trolleys were often inadequately equipped.

Matched MeSH terms: Cardiopulmonary Resuscitation
Cardiopulmonary resuscitation--training and certification in Malaysia

Mohandas K

Ann Acad Med Singap, 1992 Jan;21(1):47-50.
PMID: 1590656

Cardiopulmonary resuscitation training in Malaysia was started at the General Hospital Kuala Lumpur in 1986. Now the programme has been extended to all the General Hospitals in the country and is fully supported by the Ministry of Health. The American Heart Association curriculum for Basic Life Support is followed. From February 1986 till March 1991, the programme has trained 3982 in Basic Life Support and 548 in Advanced Cardiac Life Support. We are making efforts to translate some of the American manuals into the National language. A preliminary survey on early defibrillation indicates that majority of the physicians will allow defibrillation by non-physician.

Matched MeSH terms: Cardiopulmonary Resuscitation/education*; Cardiopulmonary Resuscitation/standards; Cardiopulmonary Resuscitation/statistics & numerical data
Fulltext Cardiopulmonary resuscitation: an essential skill not only for junior doctors but medical undergraduates and para medical staff

Sachithanandan A

Med J Malaysia, 2011 Aug;66(3):277.
PMID: 22111462
Matched MeSH terms: Cardiopulmonary Resuscitation*
Fulltext Cardiopulmonary resuscitation: would you do it?

Liew SM

Malays Fam Physician, 2006;1(2):91-93.
PMID: 27570598 MyJurnal

Recommend that the following measures be applied universally: CPR training should emphasize the very low risk of disease transmission. Training in the use of barrier mask should be included; Oral barrier devices should be made freely available in hospital and in public areas e.g. hotels, theaters, health clubs and restaurants. A survey among health personnel in Malaysia conducted in 2005 found that nearly half of the 4989 subjects were either not confident at all or unsure about their ability in giving first-aid and CPR.13 The investigators however did not look at fear of infection in particular.

Matched MeSH terms: Cardiopulmonary Resuscitation
Characteristics and Outcomes of Traumatic Cardiac Arrests in the Pan-Asian Resuscitation Outcomes Study

Lee MHM, Chia MYC, Fook-Chong S, Shahidah N, Tagami T, Ryu HH, et al.

Prehosp Emerg Care, 2023;27(8):978-986.
PMID: 35994382 DOI: 10.1080/10903127.2022.2113941

OBJECTIVE: Little is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival.
METHODS: Traumatic cardiac arrest patients from 13 countries in the Pan-Asian Resuscitation Outcomes Study registry from 2009 to 2018 were analyzed. Multilevel logistic regression was performed to identify factors associated with the primary outcomes of survival to hospital discharge and favorable neurological outcome (Cerebral Performance Category (CPC) 1-2), and the secondary outcome of return of spontaneous circulation (ROSC).
RESULTS: There were 207,455 out-of-hospital cardiac arrest cases, of which 13,631 (6.6%) were trauma patients aged 18 years and above with resuscitation attempted and who had survival outcomes reported. The median age was 57 years (interquartile range 39-73), 23.0% received bystander cardiopulmonary resuscitation (CPR), 1750 (12.8%) had ROSC, 461 (3.4%) survived to discharge, and 131 (1.0%) had CPC 1-2. Factors associated with higher rates of survival to discharge and favorable neurological outcome were arrests witnessed by emergency medical services or private ambulances (survival to discharge adjusted odds ratio (aOR) = 2.95, 95% confidence interval (CI) = 1.99-4.38; CPC 1-2 aOR = 2.57, 95% CI = 1.25-5.27), bystander CPR (survival to discharge aOR = 2.16; 95% CI 1.71-2.72; CPC 1-2 aOR = 4.98, 95% CI = 3.27-7.57), and initial shockable rhythm (survival to discharge aOR = 12.00; 95% CI = 6.80-21.17; CPC 1-2 aOR = 33.28, 95% CI = 11.39-97.23) or initial pulseless electrical activity (survival to discharge aOR = 3.98; 95% CI = 2.99-5.30; CPC 1-2 aOR = 5.67, 95% CI = 3.05-10.53) relative to asystole.
CONCLUSIONS: In traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.

Matched MeSH terms: Cardiopulmonary Resuscitation*
Characteristics and outcomes of young adults who suffered an out-of-hospital cardiac arrest (OHCA)

Chia MY, Lu QS, Rahman NH, Doctor NE, Nishiuchi T, Leong BS, et al.

Resuscitation, 2017 02;111:34-40.
PMID: 27923113 DOI: 10.1016/j.resuscitation.2016.11.019

BACKGROUND: There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes.
METHODS: All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged. Regression analysis was performed to identify factors associated with favourable neurologic outcomes.
RESULTS: 66,780 OHCAs were collected between January 2009 and December 2013; 3244 young OHCAs had resuscitation attempted by emergency medical services (EMS). 56.8% of patients had unwitnessed arrest; 47.9% were of traumatic etiology. 17.2% of patients (95% CI: 15.9-18.5%) had return of spontaneous circulation; 7.8% (95% CI: 6.9-8.8%) survived to one month; 4.6% (95% CI: 4.0-5.4%) survived with favourable neurologic outcomes. Factors associated with favourable neurologic outcomes include witnessed arrest (adjusted RR=2.42, p-value<0.0001), bystander CPR (adjusted RR=1.57, p-value=0.004), first arrest shockable rhythm (adjusted RR=27.24, p-value<0.0001), and cardiac etiology (adjusted RR=3.99, p-value<0.0001).
CONCLUSIONS: OHCA among young adults are not uncommon. Traumatic OHCA, occurring most frequently in young adults had dismal prognosis. First arrest rhythms of VF/VT/unknown shockable rhythm, cardiac etiology, bystander-witnessed arrest, and bystander CPR were associated with favourable neurological outcomes. The results of the study would be useful for planning preventive and interventional strategies, improving EMS, and guiding future research.

Matched MeSH terms: Resuscitation; Cardiopulmonary Resuscitation

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