Doctors from the Singapore General Hospital (SGH) will be conducting a world’s first trial to find out if delivering electrical shocks (defibrillation) at a specific time during cardiopulmonary resuscitation (CPR) can improve survival for cardiac arrest patients.
Cardiac arrest patients who are brought to SGH’s Emergency Department with severely abnormal heart rhythm are eligible and may be enrolled in the study from April this year.
Currently, patients who are brought to the Emergency Departments across the island are given CPR and electrical shocks immediately to normalise the heart rhythm. However, manual CPR has to be paused during defibrillation. With the advent of automated CPR machines, defibrillation can now be synchronised during CPR. This can potentially increase shock success as previously shown in animal studies.
In this study, the automated CPR machine and defibrillator will be programmed to give an electrical shock to the patient’s heart at a pre-determined phase of chest compression. Patients in one group of the study will be defibrillated during a point when pressure is taken off the chest while the second group will be defibrillated at the pre-compression phase which is the current standard of care. Pre-compression phase is the period between each complete chest compression.
Cardiac arrest victims have very little chance of survival unless someone starts CPR immediately to sustain him or her until medical help arrives. It is totally unpredictable and can strike anyone, anywhere at anytime.
“Once at the hospital, doctors will provide the necessary treatment to revive patients without delay. The shorter the time from collapse to defibrillation, the better the chances of survival. The longer defibrillation is delayed, the lower the survival rate,” said Associate Professor Marcus Ong, Senior Consultant, Department of Emergency Medicine, SGH.
“SGH sees between 150 and 200 cardiac arrests patients at the Emergency Department each year. We want to increase patients’ chances of survival and improve clinical outcome once they come through our door by studying if survival can be improved by synchronising defibrillation with chest compression. The study has the potential to significantly impact current practice of resuscitation,” added Prof Ong, who is leading the study.
The study aims to enroll 142 patients with half of them randomly assigned to either group of the study.
SGH will be organising a Community Forum titled: “Surviving a Cardiac Arrest: What You Need to Know” on Saturday, 17 March 2012 to inform the public about the study and also to educate them on what they need to do in the event that a family member or friend goes into cardiac arrest in their presence.
The event will be held at SGH Deck on 9 at Block 6, Level 9 from 2pm to 4pm. It will be in English and will be free for participants.