• Ivan S Y Chua, Fook-ChongStephanie M CSMCPrehospital & Emergency Research Centre, Duke-NUS Medical School, Singapore., Nur Shahidah, Yih Yng Ng, ChiaMichael Y CMYCEmergency Department, Tan Tock Seng Hospital, Singapore., Desmond R Mao, LeongBenjamin S HBSHEmergency Medicine Department, National University Hospital, Singapore., Si Oon Cheah, Han Nee Gan, Nausheen E Doctor, Lai Peng Tham, OngMarcus E HMEHDepartment of Emergency Medicine, Singapore General Hospital, Singapore; Health Services & Systems Research, Duke-NUS Medical School, Singapore., and Singapore PAROS investigators.
• Department of Emergency Medicine, Singapore General Hospital, Singapore. Electronic address: ivan.chua.s.y@singhealth.com.sg.
• Resuscitation. 2022 Apr 1; 173: 136-143.

ObjectiveWe aimed to examine the survival outcomes of out-of-hospital cardiac arrest (OHCA) patients, stratified by the transportation modes to the Emergency Department (ED).MethodsThis was a retrospective analysis of Singapore's Pan-Asian Resuscitation Outcomes Study registry from Apr 2010-Dec 2017. The primary outcome was survival to discharge or 30 days post-arrest. Secondary outcomes were the return of spontaneous circulation (ROSC) rate and neurological outcomes. A subgroup analysis was performed for OHCA cases who collapsed enroute.ResultsA total of 15,376 cases were analysed. 15,129 (98.4%) were conveyed by Emergency Medical Services (EMS), 111 (0.72%) by private ambulance, 106 (0.69%) by own transport and 30 (0.2%) by public transport. 80% of patients brought by public transport arrested enroute, compared to 48.1% by own transport, 25.2% by private ambulance and 2.5% in the EMS group. 33/120 (27.5%) of paediatric OHCA cases were brought in by non-EMS transport to paediatric hospitals. The EMS group had the lowest survival rate at 4.5%, compared to 13.3% for public transport, 11.3% for own transport and 14.4% for private ambulance. ROSC rate was statistically significant but not for neurological outcomes. For the subgroup analysis, there was no statistical difference for primary and secondary outcomes across the groups.ConclusionIn Singapore, most OHCA patients are conveyed by EMS to the hospital, but some OHCA patients still arrive via alternative transport without prehospital interventions like bystander CPR. More can be done to educate the public to recognise an impending cardiac arrest and to activate EMS early for such cases.Copyright © 2022 Elsevier B.V. All rights reserved.

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