Singapore has made significant progress over the past 15 years in increasing the survival
rates of cardiac arrest victims. Between 2001 and 2015, victims who survived cardiac arrest rose from 2.5 per cent to 21.3 per cent. Nevertheless, more can be done to enhance the victims’ chances of survival.

2. Therefore, as part of the continuous efforts to boost survival rates for persons who suffer out-of-hospital cardiac arrest, the Singapore General Hospital (SGH) and Singapore Civil Defence Force (SCDF) will be introducing the following four ambulance-based interventions progressively over the next four years, starting from January 2018: 
a) Manual defibrillation; 
b) High-performance team cardiopulmonary resuscitation (CPR); 
c) Impedance threshold device; and 
d) Intravenous amiodarone 

3. These four interventions are evidence-based and have been proven to improve the survival of cardiac arrest patients. In many countries, paramedics have been trained to administer these interventions with good safety and outcomes. The SCDF Medical Advisory Committee has supported the introduction of these ambulance-based interventions. Details of the interventions are at ANNEX.

4. Assigned doctors from the public hospitals have been training SCDF paramedics on these interventions since Nov 2017. All SCDF paramedics will be progressively trained in the interventions, and only trained personnel will be allowed to perform these four ambulance-based interventions. The public hospitals and SCDF will regularly evaluate the safety as well as efficacy of these interventions.

5. Associate Professor Marcus Ong, Senior Consultant, Department of Emergency Medicine (SGH) and Medical Director, UPEC (MOH) said: “We have been partnering SCDF in rolling out various interventions to improve the survival rate of cardiac arrest victims. It is our hope that more lives can be saved by the paramedics through the timely administration of ambulance-based interventions. Beyond SCDF and hospitals, the assistance provided by the public is pivotal. Specifically, the public can help by calling 995, performing CPR, and using an Automated External Defibrillator (AED) when they see someone collapse. In this regard, we are heartened that the local bystander CPR rate, has improved from 22 per cent in 2011 to 54.1 per cent in 2015.”

6. COL (Dr) Ng Yih Yng, Chief Medical Officer (SCDF) said: “Continuous professional training and skills upgrading are part and parcel of being an SCDF paramedic. Our paramedics are trained and ready to administer these ambulance-based interventions as part of SCDF’s higher standard of care for cardiac arrest victims, potentially making a difference to their survival.”