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HKU Advocates Extensive CPR and AED Training to Enhance Out-of-hospital Cardiac Arrest Survival Rate

20 Dec 2016

A survey conducted last year by the Emergency Medicine Unit (EMU), Li Ka Shing Faculty of Medicine, The University of Hong Kong (HKU) found that the public generally lacked first-aid skills and knowledge, resulting in the survival rate of out-of-hospital cardiac arrest (OHCA) cases in Hong Kong ranking the lowest in Asia.  To enhance the survival rate of these patients, HKU has initiated a series of community projects, including the development of mobile application and e-learning platform, promotion of “Compression-only Cardiopulmonary Resuscitation (CPR)” teaching in secondary schools, and organisation of CPR workshops and seminars, aiming at raising the general public’s knowledge on first-aid and Automated External Defibrillator (AED).  

Time critical to rescue OHCA victims

Out-of-hospital cardiac arrest (OHCA) is the sudden, unexpected loss of heart function, breathing and consciousness that happen outside hospitals.  It is one of the leading causes of death globally and Hong Kong is no exception.  Resuscitation of OHCA victims is time critical.  The performance pledge of the ambulance service is to arrive at patient’s side within 12 minutes.  However, the survival rate decreases 7-10% per minute without CPR.  Therefore, chance of survival is very low if nothing is done by bystander before arrival of ambulance.  From data collected by EMU of Li Ka Shing Faculty of Medicine, HKU between 2012 and 2013 also showed that the survival rate of OHCA cases  in Hong Kong was only 2.3%, which is among the lowest in Asia.

Public lacks first-aid knowledge and skills

A face-to-face semi-structured questionnaire survey of the public was conducted by the Emergency Medicine Unit of Li Ka Shing Faculty of Medicine, HKU in November and December 2015 in six locations in Hong Kong with a high pedestrian flow.  401 respondents, aged 16 or above, have been interviewed.  The response rate was 58%.  The study aimed to evaluate the public knowledge about the use of an AED in OHCA in Hong Kong.  The survey found that only 22% of respondents received first-aid training and 12% of respondents received both first-aid and AED training.  

In emergency situation like OHCA, despite 97% of respondents showed willingness to make the emergency call (999), only 21% of them were willing to conduct CPR for the victim.  Even worse, less than 18% of respondents were willing to apply AED to the victim. 

The research team has also found that bystanders who attended both first-aid and AED training courses have significant improvement in their life-saving skills and knowledge.  They are more likely to respond appropriately in emergency situation.  67% respondents who only received first-aid training said they would not apply CPR and 78% claimed they would not apply AED even if AED is available.  In contrast, only 27% and 22% of AED trained first-aiders claimed that they would not apply CPR and AED respectively.  The difference of attitude between the groups is noticeable. 

Dr Leung Ling-pong, Clinical Associate Professor, Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, HKU commented that, “from the figures, Hong Kong general public lacks first-aid skills and knowledge.  Most of them would not apply CPR to the OHCA victims.  The knowledge on AEDs is also very low.  These factors contribute to low AED application rate in Hong Kong.”

Dr Leung added, “The research findings are encouraging.  It showed that if the first-aiders attended AED training course, the improvement is significant.”  Therefore, it is crucial and necessary to increase the first-aiders and improve the knowledge of the general public.  Otherwise, the effect of Public Accessible Defibrillator (PAD) programme is limited. 

Collaboration with different stakeholders in community projects

The Emergency Medicine Unit of Li Ka Shing Faculty of Medicine, HKU has initiated a series of community projects to improve first-aid knowledge of general public, including elderly CPR course and Filipino domestic workers CPR workshops and seminars.  Most recently, EMU was funded by the Quality Education Fund (QEF) to promote “Compression-only CPR” teaching in 30 secondary schools.  The project will commence in 2017 and combine mobile application and e-learning platform to teach CPR.  Over 15,000 students will be benefited.  This programme will be the first compression-only CPR teaching programme in secondary schools of Hong Kong.

EMU has also developed a mobile app “HKUEMU AED” that allows users to search and locate the AED nearby whenever it is needed in emergency.  Dr Ko Wing-man, Secretary for Food and Health, Mr Lai Man-hin, former Director of Fire Services; Dr Axel Siu Yuet-chung, Consultant of Accident & Emergency Department, North District Hospital; and popular musical band RubberBand to film promotion clips of CPR to increase public awareness. 

Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong

Established in late 2014, the Emergency Medicine Unit is dedicated to advancing the specialty of Emergency Medicine and benefitting the society through teaching, research, knowledge exchange and clinical service. 

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To use the press release photo(s) for any publishing, publicity and related purpose, photo courtesy should be given to “Li Ka Shing Faculty of Medicine, The University of Hong Kong”.

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Dr Leung Ling-pong, Clinical Associate Professor, Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, HKU, advocates that compression-only CPR and AED training should be enhanced in Hong Kong.

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Dr Leung Ling-pong, Clinical Associate Professor, Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, HKU, points out that the survey conducted by HKU reflects the general public in Hong Kong lacks first-aid skills and knowledge.

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The Emergency Medicine Unit of Li Ka Shing Faculty of Medicine, HKU has developed a mobile app “HKUEMU AED” that allows users to search and locate the AED nearby whenever it is needed in emergency.