Displaying publications 1 - 20 of 65 in total

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  1. Azhar AA
    Med J Malaysia, 1999 Jun;54(2):257-60.
    PMID: 10972038
    A mass CPR (cardio-pulmonary resuscitation) teaching programme, believed to be the first in Malaysia, was held at the Dewan Tunku Canselor, University of Malaya (UM) on Saturday, 13th July 1996. Organised by the Resuscitation Committee of University Hospital, Kuala Lumpur, this programme was conducted for 200 first year UM students. We describe the organisation of this non-traditional and non-threatening, new CPR teaching programme and propose that this be further developed for the dissemination of CPR skills to our Malaysian public.
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  2. Lee HT, Low BT
    Med J Malaysia, 1999 Jun;54(2):167-8.
    PMID: 10972024
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  3. 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
  4. Low DW, Looi I, Manocha AB, Ang HA, Nagalingam M, Ayop NA, et al.
    Med J Malaysia, 2012 Oct;67(5):538-9.
    PMID: 23770879 MyJurnal
    A report of a patient with Lazarus phenomenon (the return of spontaneous circulation after cardiopulmonary resuscitation) following cardiac arrest (myocardium ischemia) is presented. A 65 year patient was found unconscious at home. He taken to the emergency department On arrival he was unconscious, his pupils fixed and dilated bilaterally. Resuscitation proceeded for 55 minutes. He was then pronounced dead. Forty minutes later spontaneous breathing was noted and his blood pressure was 110/48 and heart rate 90bpm. He survived a further 13 days in the coronary care unit. The implications for management of cardiac arrest in the emergency and medical department are discussed.
    Matched MeSH terms: Cardiopulmonary Resuscitation*
  5. Fazel MF, Mohamad MHN, Sahar MA, Juliana N, Abu IF, Das S
    Int J Environ Res Public Health, 2022 Sep 02;19(17).
    PMID: 36078684 DOI: 10.3390/ijerph191710968
    Early cardiopulmonary resuscitation (CPR) is a strong link in the of survival for sudden cardiac arrest. Hence, bystander CPR (BPCR) plays an important role in curbing mortality and morbidity from out-of-hospital sudden cardiac arrest. However, the recent global Coronavirus disease 2019 (COVID-19) pandemic has impacted both public training and confidence in performing out-of-hospital CPR. This paper reviews detailed information from databases including Google Scholar, Scopus, PubMed and Web of Science on the readiness of BCPR during the pandemic. We also discussed the challenges bystanders encountered during the COVID-19 pandemic and the precautions to follow. Finally, we also highlighted the limitations which would benefit future endeavours in establishing well-planned and sustainable CPR training programs for the public. Therefore, regardless of the existing COVID-19 pandemic, BCPR must be emphasised to curb out-of-hospital cardiac arrest (OHCA) mortality.
    Matched MeSH terms: Cardiopulmonary Resuscitation*
  6. 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*
  7. Osman A, Norsidah AM
    Med J Malaysia, 1997 Dec;52(4):399-401.
    PMID: 10968117
    There is now increased public awareness of the value and role of cardiopulmonary resuscitation (CPR). It is therefore not surprising that the public expects a reasonable level of expertise of medical doctors in the application of the CPR techniques during emergency situations. Newly qualified doctors often lack confidence and are usually at a loss when faced with such situations as they have never had practical training before graduation. Most doctors are gradually introduced to CPR as part and parcel of their clinical experience. Many begin to attend formal CPR workshops later in their careers. Medical schools are expected to produce well trained doctors who are competent in clinical practice which include the techniques of basic resuscitation. By virtue of their expertise in airway management and clinical resuscitation, anaesthesiologists can significantly contribute to the teaching of CPR in the undergraduate medical curriculum. This is a retrospective review of Basic Life Support programmes conducted at the Department of Anaesthesiology, Faculty of Medicine, Universiti Kebangsaan Malaysia.
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  8. 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*
  9. Daud A, Nawi AM, Aizuddin AN, Yahya MF
    Glob Heart, 2023;18(1):46.
    PMID: 37649652 DOI: 10.5334/gh.1255
    BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) can improve out-of-hospital cardiac arrest survival. However, bystander CPR and AED rates remained consistently low. The goal of this systematic review was to assess factors influencing community willingness to perform CPR and use an AED for out-of-hospital cardiac arrest survival (OHCA) victims, as well as its barriers.

    METHODS: The review processes (PROSPERO: CRD42021257851) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review protocol; formulation of review questions; systematic search strategy based on identification, screening, and eligibility using established databases including Scopus, Web of Science, and Medline Complete via EBSCOhost; quality appraisal; and data extraction and analysis. There is identification of full-text journal articles that were published between 2016 and 2021 and written in English.

    RESULTS: Of the final 13 articles, there are six identified factors associated with willingness to perform CPR and use an AED, including socio-demographics, training, attitudes, perceived norms, self-efficacy, and legal obligation. Younger age, men, higher level of education, employed, married, having trained in CPR and AED in the previous 5 years, having received CPR education on four or more occasions, having a positive attitude and perception toward CPR and AED, having confidence to perform CPR and to apply an AED, and legal liability protection under emergency medical service law were reasons why one would be more likely to indicate a willingness to perform CPR and use an AED. The most reported barriers were fear of litigation and injuring a victim.

    CONCLUSIONS: There is a need to empower all the contributing factors and reduce the barrier by emphasizing the importance of CPR and AEDs. The role played by all stakeholders should be strengthened to ensure the success of intervention programs, and indirectly, that can reduce morbidity and mortality among the community from OHCA.

    Matched MeSH terms: Cardiopulmonary Resuscitation*
  10. 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*
  11. Iqhbal KM, Mokhtar NAM, Isa MR, Mokhtar MF
    Med J Malaysia, 2023 Sep;78(5):639-645.
    PMID: 37775492
    INTRODUCTION: There are insufficient data available regarding the outcome of cardiac arrest (CA) resuscitated in the emergency department in Malaysia. This study aims to determine the incidence of CA, the return of spontaneous circulation (ROSC), survival to admission (STA), survival to discharge (STD) and factors influencing the overall outcome of CA.

    MATERIAL AND METHODS: This is a retrospective observational study done in Hospital Sg Buloh (HSB), a tertiary referral centre in an urban area located north of Kuala Lumpur, Malaysia's capital city, from January until December 2018, involving 289 patients. All cases with CPR and a sustained return of spontaneous circulation (ROSC) were included in the study and followed up until discharged or died in the hospital.

    RESULTS: Out of 236 patients recruited, 25.8% achieved ROSC, 15.7% survived on admission, and 4.2% of patients were discharged alive. Of 74.1% of witnessed OHCA, only 17.5% received bystander CPR. Factors with favourable outcomes include CA in ED (p<0.001), the initial rhythm of ventricular fibrillation (p=0.003), defibrillation (p=0.024), OHCA witnessed by emergency medical services (EMS) (p=0.024) and intravenous adrenaline administration (p=0.001). When using multivariate regression analysis, positive outcomes were associated with the cardiac and respiratory cause of CA (Adjusted Odd Ratio (AOR) 3.66; 95% Confidence Intervals, 95%CI: 2.52 - 12.61 and AOR 8.76; 95%CI: 5.76- 15.46, respectively) as well as OHCA witnessed by EMS (AOR 10.81; 95%CI: 1.84- 19.52).

    CONCLUSIONS: Despite being an upper-middle-income country and having advancements in the healthcare system, a relatively lower STD rate among survivors of CA in the ED was observed in this study. There was underutilization of the EMS among patients with CA. The bystander CPR rate among patients with CA in Malaysia is also worryingly low. Aggressive community participation in cardiac arrest awareness programmes is much required. Additionally, in achieving better outcomes, implementing standardized post-resuscitation care protocols with existing resources will be a challenge for physicians managing cardiac arrest cases.

    Matched MeSH terms: Cardiopulmonary Resuscitation*
  12. Rozali, A., Khairuddin, H., Sherina, M.S., Chia, L.M.
    MyJurnal
    Lightning strikes have been known to cause fatal injuries. However, these cases have not been adequately highlighted in Malaysia. This paper reports on three cases of military personnel who lost their lives after being struck by lightning while on operational duties. It is extremely important to implement adequate safety measures and ensure that all military personnel are adequately trained on emergency procedures, such as Cardio Pulmonary Resuscitation (CPR) to prevent casualties of lightning strikes in future. This paper addresses several issues to avoid similar occurrences; the importance of taking extra safety precautions and recognizing signs of lightning strikes, as well as the immediate administration of CPR on victims.
    Matched MeSH terms: Cardiopulmonary Resuscitation
  13. 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
  14. 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
  15. 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*
  16. Chew KS, Idzwan ZM, Hisamuddin NA, Kamaruddin J, Wan Aasim WA
    Med J Malaysia, 2008 Mar;63(1):4-8.
    PMID: 18935723 MyJurnal
    Despite the progresses made in the science of cardiopulmonary resuscitation, there is lack of published works on this area in the Malaysian context. This survey was done to look at the outcomes of all cardiopulmonary resuscitation performed in Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM). This is a one year cross-sectional study from March 2005-March 2006. All adult cardiac arrest cases with CPR performed in ED, HUSM were included in the survey. The end points are return of spontaneous circulation (ROSC) and survival to ward admission. Out of the total 63 cases of cardiac arrest with CPR performed, only 19 cases (30.2%) had ROSC after CPR performed on them. Eventually only six patients (9.5%) had survival to ward admission. Patients with shockable intial arrest rhythm has a significantly higher chance to achieve ROSC (60.0%) compared to non-shockable rhythms (24.5%) (p = 0.025). However, there was no different in survival to ward admission between shockable and non shockable rhythms groups. The survival after cardiac arrest is still dismally poor. Perhaps we should be more selective in initiating CPR especially for out of hospital cardiac arrest.
    Matched MeSH terms: Cardiopulmonary Resuscitation*
  17. Chelladurai G, Noor Azhar AM, Mohd Isa R, Bustam A, Ahmad R, Munisamy M
    Med J Malaysia, 2020 09;75(5):514-518.
    PMID: 32918419
    INTRODUCTION: Cardiopulmonary Resuscitation (CPR) remains the primary mechanism of resuscitation for cardiac arrest victims. However, the quality of delivery of CPR varies widely in different settings, possibly affecting patient outcomes. This study is aimed to determine the efficacy of an audio-visual (AV) CPR feedback device in improving the quality of CPR delivered by healthcare providers.

    METHODS: This pre-post, single-arm, quasi-experimental study randomly sampled 140 healthcare providers working in the Emergency Department of Hospital Ampang, Malaysia. Parameters of CPR quality, namely chest compression rate and depth were compared among participants when they performed CPR with and without an AV CPR feedback device. The efficacy of the AV CPR feedback device was assessed using the Chi-square test and Generalised Estimating Equations (GEE) models.

    RESULTS: The use of an AV CPR feedback device increased the proportion of healthcare providers achieving recommended depth of chest compressions from 38.6% (95% Confidence Interval, 95%CI: 30.5, 47.2) to 85.0% (95%CI: 78.0, 90.5). A similar significant improvement from 39.3% (95%CI: 31.1, 47.9) to 86.4% (95%CI: 79.6, 91.6) in the recommended rate of chest compressions was also observed. Use of the AV CPR device significantly increased the likelihood of a CPR provider achieving recommended depth of chest compressions (Odds Ratio, OR=13.01; 95%CI: 7.12, 24.01) and rate of chest compressions (OR=13.00; 95%CI: 7.21, 23.44).

    CONCLUSION: The use of an AV CPR feedback device significantly improved the delivered rate and depth of chest compressions closer to American Heart Association (AHA) recommendations. Usage of such devices within real-life settings may help in improving the quality of CPR for patients receiving CPR.

    Matched MeSH terms: Cardiopulmonary Resuscitation/standards*
  18. Liu N, Ong MEH, Ho AFW, Pek PP, Lu TC, Khruekarnchana P, et al.
    Resuscitation, 2020 04;149:53-59.
    PMID: 32035177 DOI: 10.1016/j.resuscitation.2020.01.029
    AIM: Survival is the most consistently captured outcome across countries for out-of-hospital cardiac arrests (OHCA), with return of spontaneous circulation (ROSC) representing the earliest endpoint for 'unbiased' initial resuscitation success. The ROSC after cardiac arrest (RACA) score was developed to predict ROSC and has been validated in several European countries. In this study, we aimed to evaluate the performance of RACA in a Pan-Asian population.

    METHODS: We conducted a retrospective analysis of data collected in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry. We included OHCA cases from seven communities (Japan, South Korea, Malaysia, Singapore, Taiwan, Thailand, and United Arab Emirates) between January 2009 and December 2012. Paediatric cases, cases that were conveyed by non-emergency medical services (EMS), and cases with incomplete records were excluded from the study.

    RESULTS: The RACA score showed similar discrimination performance as the original German study and various European validation studies. However, it had poor calibration with the original constant regression coefficient, which was primarily due to the low ROSC rate (8.2%) in the PAROS cohort. The calibration performance of RACA significantly improved after the constant coefficient was modified to adjust for the disparity in ROSC rates between Asia and Europe.

    CONCLUSION: This is the largest validation study of the RACA score. RACA consistently performs well in both Pan-Asian and European communities and can thus be a valuable tool for evaluating EMS systems. However, to implement it, the constant coefficient has to be modified in the RACA formula with local historical data.

    Matched MeSH terms: Cardiopulmonary Resuscitation*
  19. Karuthan SR, Firdaus PJFB, Angampun ADG, Chai XJ, Sagan CD, Ramachandran M, et al.
    Medicine (Baltimore), 2019 Dec;98(51):e18466.
    PMID: 31861024 DOI: 10.1097/MD.0000000000018466
    Worldwide, millions of people die of sudden cardiac arrest every year. This is partly due to limited and sometimes ineffective bystander cardiopulmonary resuscitation (CPR). The need for mouth-to-mouth contact, fear of causing harm, litigation, and the complexity of delivering CPR are the main deterrents. In view of this, the basic life support algorithm has been simplified and lay rescuers are encouraged to perform Hands-Only CPR.The objective of this study is to assess knowledge on and willingness to perform Hands-Only CPR among Malaysian college students and to determine the relationship between the two.In an online self-administered survey, college students responded to a questionnaire on demographics, exposure to CPR, knowledge on Hands-Only CPR, and their willingness to perform Hands-Only CPR in 5 different scenarios (family members or relatives, strangers, trauma victims, children, and elderly people).Data for 393 participants were analyzed. For knowledge, the mean score was 8.6 ± 3.2 and the median score was 9. In the sample, 27% of the respondents did not attend any CPR training before, citing that they were unsure where to attend the course. The knowledge score among those who attended CPR training (M = 3.6, S = 2.9) was significantly higher compared to those who did not (M = 6.7, S = 3.0). Out of the 393 participants, 67.7%, 55%, 37.4%, 45%, and 49.1% were willing to perform Hands-Only CPR on family members or relatives, strangers, trauma victims, children, and elderly people, respectively. There were significant associations (P 
    Matched MeSH terms: Cardiopulmonary Resuscitation*
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