This document summarizes data from the Pan Asian Resuscitation Outcomes Study (PAROS) clinical research network on out-of-hospital cardiac arrests across several Asian countries from 2009-2012. Key findings include: total cases reported were over 66,000 with wide variation in bystander CPR rates between countries (10.5-42.4%); survival rates for witnessed ventricular fibrillation arrests ranged from no reported survivors to 31.2%; overall survival to hospital discharge was 1.3-8.9% with good neurological function less than 5% for all countries. Baseline characteristics like age, gender, location of arrest varied significantly between participating countries in the PAROS study.

1. A/Prof Marcus Ong Eng Hock
Senior Consultant, Clinician Scientist and Director of Research
Department of Emergency Medicine, Singapore General Hospital
Associate Director, Health Services and Systems Research
Duke-NUS Graduate Medical School, Singapore
The Pan Asian Resuscitation
Outcomes Study (PAROS)

2. Top 10 Causes of death by Country
Korea Singapore Taiwan Japan Thailand Malaysia Turkey UAE
1 Cancer Cancer Cancer Cancer Cerebrovasc
ular disease
Ischemic
heart
disease
Ischemic
heart
disease
Ischemic
heart
disease
2 Cerebrovas
cular
disease
Ischemic
Heart
disease
Heart
disease
Heart
disease
Malignant
neoplasm
Pneumonia Malignant
neoplasm
Road
traffic
accidents
3 Heart
disease
(IHD + etc)
Pneumonia Cerebrovasc
ular disease
Cerebrovasc
ular disease
Ischemic
heart
disease
Cerebrovas
cular
disease
Cerebrovas
cular
neoplasm
Malignant
neoplasm
4 Suicide Cerebrovasc
ular disease
Pneumonia Pneumonia Diabetes
mellitus
Septicaemi
a
Chronic
obstructive
pulmonary
disease
Cerebrova
scular
disease
5 Diabetes
Mellitus
Accident,
Poisoning &
Violence
Diabetes
Mellitus
Senility Chronic
obstructive
pulmonary
disease
Transport
accident
Lower
respiratory
infections
Hypertens
ive heart
disease

3.  In 2010, Pan Asian Resuscitation Outcomes
Study (PAROS) Clinical Research Network
(CRN) was established in collaboration with
Japan, Singapore, South Korea, Malaysia,
Taiwan,Thailand, and UAE-Dubai.
 This CRN aims to report the out-of-hospital
cardiac arrests (OHCA) events and provide a
better understanding of OHCA trends in Asia.

4. IMPROVEMENTS
IN SURVIVAL FOR
OUT-OF-HOSPITAL
CARDIAC ARREST
IN SINGAPORE
OVER 10 YEARS
PEC Steering Committee Meeting
26 February 2014

5. Methodology
Comparison of Out-of-Hospital Cardiac Arrest Cases
Database No. of
cases
Cardiac Arrest and Resuscitation Epidemiology
(CARE)
Oct 2001 – Oct 2004
2428
Pan Asian Resuscitation Outcomes Study (PAROS)
Apr 2010 – May 2012
3025
Total 5453

6. Characteristics
CARE
(n=2428)
PAROS
(n=3025)
Age Mean (SD) 60.6 (19.3) 63.5 (18.2)
Median (Range) 63.4 (50.4-74.4) 65.0 (53.0-77.0)
Gender (%) Male 1652 (63.0) 1988 (65.7)
Race (%)
Chinese 1687 (69.5) 2009 (66.4)
Malay 365 (15.0) 459 (15.2)
Indians 267 (11.0) 343 (11.3)
Others 108 (4.5) 214 (7.0)
Medical History (%)
No 282 (11.6) 383 (12.6)
Unknown 482 (19.9) 289 (9.4)
Heart Disease 788 (32.5) 1090 (35.9)
Diabetes 569 (23.4) 869 (28.7)
Hypertension 752 (31.0) 1430 (47.1)
Other 436 (18.0) 1058 (35.0)
Characteristics of Patients

7. Characteristics
CARE
(n=2428)
PAROS
(n=3025)
Location (%)
Home Residence 1703 (70.1) 2128 (70.0)
Healthcare Facility 103 (4.2) 110 (3.6)
Public/Commercial
Building
173 (7.1) 237 (7.8)
Industrial Place 43 (1.8) 63 (2.1)
Nursing Home 35 (1.4) 111 (3.7)
Place of Recreation 22 (0.9) 57 (1.9)
Street/Highway 108 (4.4) 155 (5.9)
Transport centre 36 (1.5) 37 (1.2)
In EMS/Private ambulance 67 (2.8) 69 (2.3)
Other 86 (3.5) 60 (2.0)
Characteristics of Patients

8. CARE
n=2428
PAROS
n=3025
P value
All Arrests
Bystander CPR present 478 (19.7) 678 (22.4) 0.02
Bystander AED applied 0 (0.0) 55 (1.8) -
Public access defibrillation 0 (0.0) 29 (1.0) -
Mechanical CPR device used 0 (0.0) 252 (8.3) -
Pre-hospital defibrillation 508 (22.4) 698 (23.1) 0.90
Pre-hospital advanced airway 0 (0.0) 2390 (79.0) -
Pre-hospital drug administration 303 (13.4) 1417 (46.8) <0.001
Post-Resuscitation Care (%)
ECMO therapy 0 (0.0) 2 (0.1) -
Hypothermia therapy 0 (0.0) 29 (1.0) -
Resuscitation Factors

9. CARE
n=2428
PAROS
n=3025
P value
EMS time intervals in minutes, median (IQR)
For arrests that occurred before EMS
arrival:
Time of arrest – Time of call
6.4 (2.7– 13.0)
n=1546
5.8 (2.3-12.5)
n=2148
<0.20
For arrests that occur after EMS
arrival:
Time of call – Time of arrest
7.7 (2.8-18.0)
n= 627
6.33 (1.81-15.8)
n=720
0.04
FRP dispatch – FRP arrival at scene - 5.00 (4-7) -
Call to arrival at scene 9 (6.8-11.42) 7.96 (6.0-10.3) <0.001
Call to arrival at patient side 11.1 (9.0-14.0) 9.93 (7.8-12.6) <0.001
Arrival at patient side to leave scene 10.0 (7.0-12.6) 12.1 (10.0-14.7) <0.001
Leave scene to arrival at hospital 10.0 (7.0-14.2) 10.0 (7.0-13.9) 0.10
Call to ED 32.3 (27.4-38.1) 33.2 (28.4-38.5) 0.02
Resuscitation Factors

10. CARE
n=2428
PAROS
n=3025
Adjusted OR*
(95% CI)
Survival - All Arrests
Admitted 215 (9.0) 514 (17.0) 2.2 (1.8 - 2.6)
Discharged alive or Alive at
30 days
38 (1.6) 97 (3.3) 2.2 (1.5 - 3.3)
Post Arrest CPC 1/2 28 (1.2) 53 (1.8) 1.7 (1.1 - 2.8)
Survival - Utstein Style
Admitted 16/280 (5.7) 82/317 (26.8) 9.6 (3.9 – 23.3)
Discharged alive or Remain
alive at 30 days
7/280 (2.5) 35/317 (11.0) 9.6 (2.2 – 41.9)
Post Arrest CPC 1/2
6/280 (2.1) 22/317 (7.0) 6.0 (1.3 – 27.0)
*adjusted for age, gender, and history of heart disease
Survival for All Arrests and Utstein Arrests

11. Variables
Unadjusted OR
(95% CI)
Adjusted OR
(95% CI)
Bystander CPR 1.9 (1.3 - 2.8) 1.1 (0.7 – 1.9)
Bystander AED 5.0 (2.1 - 11.9) 4.0 (1.3 - 11.7)
Response time 8 min or less 1.8 (1.3 – 2.6) 1.3 (0.8 - 2)
Ambulance defibrillation 5.9 (3.9 - 9.0) 1.2 (0.4 – 3.6)
Mechanical CPR by EMS 1.3 (0.7 – 2.5) 1.5 (0.7 – 3.2)
Pre-hospital Advanced Airway 1.0 (0.7 - 1.4) 0.2 (0.1 - 0.3)
Epinephrine 0.5 (0.3 – 0.8) 0.5 (0.3 - 0.9)
Hypothermia 19 (8.5 - 42.4) 27 (10.0 – 72.8)
Multivariate Analysis of Factors Important for Survival

12. 10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Dispatcher Assisted CPR Rate (Jun 2012-Aug 2013)

13. Conclusion
• Additional 30+ lives are saved per year from OHCA compared to
10 years ago (20 survivors/year). More than half of them will go
back to a normal, independent, productive life.
• Greatest benefit seen from more public AEDs, hypothermia post
resuscitation, also possibly from more bystander CPR, faster
response time and ambulance care (defibrillation).
• Great potential for dispatcher-assisted CPR and AED to further
improve survival.

14. Participating Countries

17.  A prospective, international, multi-center cohort
study of OHCA across the Asia-Pacific.
 Each participating country provided between 1.5
to 2.5 years of data from January 2009 to
December 2012.
 A standardised taxonomy and case record form
are adopted to collect common variables.
 Data were provided via two methods; using
electronic data capture system which is an online,
data registry or exported data from national
registry.

18. Accomplishments so far

19. Country City
Service area
population
Population
density
(per KM2)
Data Source
No. of
ambulances
No. of
hospitals
Japan Aichi 7,434,996 1,439.46 EMS-centric 249 155
Japan Osaka 8,860,280 4,659.82 EMS-centric 285 272
Japan Tokyo 13,286,735 6,070.69 EMS-centric 218 276
Korea Seoul 10,249,679 16,941.6 EMS-centric 140 63
Malaysia Klang Valley 1,749,059 6,932.39 Hospital-centric 5 2
Malaysia Kota Bahru 491,237 1,247 Hospital-centric 30 2
Malaysia Penang 1,520,143 1,500 EMS-centric 7 1
Singapore Singapore 5,076,700 7,252.43 EMS-centric 46 7
Thailand Bangkok 2,521,240 19,014.36 Hospital-centric 16 2
Thailand Songkla 55,144 1,326.53 Hospital-centric 4 1
Taiwan Taipei 2,650,968 271.8 EMS-centric 50 22
UAE Dubai 2,003,170 474.79 EMS-centric 68 5

20. Total of 66,786 cases from January 2009 to
December 2012 were submitted to the
PAROS CRN.
Resuscitation attempted by EMS and
presumed cardiac etiology = 40,463 cases
Bystander CPR rates varied greatly for
different countries from 10.5% to 42.4%.
However < 1.0% of all these arrests received
bystander defibrillation.

21. For arrests that were witnessed andVF,
the survival rate to hospital discharge
varied from no reported survivors to
31.2%.
Overall survival to hospital discharge
varied from 1.3% to 8.9% and overall
survival with good neurological function
was <5% for all countries.

22. Characteristics
Japan
(n=51381)
Korea
(n=7990)
Malaysia
(n=389)
Singapore
(n=3025)
Thailand
(n=573)
Taiwan
(n=3023)
UAE
(n=405)
Age, mean (SD) 71.7 (18.4) 63.5 (19.0) 57.0 (17.0) 63.5 (18.2) 55.7 (22.1) 70.5 (18.6) 49.7 (18.3)
Median (IQR)
76.0
(63.0, 85.0)
66.5
(52.0, 78.0)
59.0
(47.0,70.0)
65.0
(53.0,77.0)
57.0
(40.0, 74.0)
75.0
(59.0, 85.0)
50.0
(38.0, 63.0)
Male (n, %) 29760 (57.9) 5243 (65.6) 276 (71.0) 1988 (65.7) 367 (64.0) 1936 (64.1) 335 (82.7)
Location Type (n, %)
Home residence 8409 (63.0) 5057 (64.9) 278 (71.5) 2128 (70.3) 354 (61.8) 2201 (73.1) 220 (54.3)
Healthcare facility 50 (0.4) 137 (1.8) 11 (2.8) 110 (3.6) 11 (1.9) NA 7 (1.7)
Public /commercial
building
964 (7.2) 449 (5.8) 44 (11.3) 237 (7.8) 30 (5.2) 70 (2.3) 52 (12.8)
Nursing home 1555 (11.7) 286 (3.7) 6 (1.5) 111 (3.7) 7 (1.2) 240 (8.0) NA
Street/highway 809 (6.1) 465 (6.0) 26 (6.7) 155 (5.1) 86 (15.0) 238 (7.9) 71 (17.5)
Industrial place NA 95 (1.2) 1 (0.3) 63 (2.1) 5 (0.9) 78 (2.6) 18 (4.4)
Transport center NA 101 (1.3) 3 (0.8) 37 (1.2) 2 (0.3) 4 (0.1) NA
Place of recreation NA 187 (2.4) 2 (0.5) 57 (1.9) 6 (1.0) 54 (1.8) 24 (5.9)
In EMS/private
ambulance
852 (6.4) 382 (4.9) 9 (2.3) 69 (2.3) 33 (5.8) NA NA
Other 700 (5.2) 629 (8.1) 9 (2.3) 58 (1.9) 39 (6.8) 125 (4.2) 13 (3.2)

23. Characteristics (n, %)
Japan
(n=51381)
Korea
(n=7990)
Malaysia
(n=389)
Singapore
(n=3025)
Thailand
(n=573)
Taiwan
(n=3023)
UAE
(n=405)
Arrest Witnessed By
Not witnessed 30535 (59.4) 3158 (46.7) 176 (45.2) 1303 (43.1) 151 (26.4) 1939 (67.9) 205 (50.6)
Bystander 17221 (33.5) 3144 (46.5) 183 (47.0) 1483 (49.0) 373 (65.1) 630 (22.1) 186 (45.9)
EMS 3625 (7.1) 459 (6.8) 30 (7.7) 239 (7.9) 49 (8.6) 288 (10.1) 14 (3.5)
First Arrest Rhythm
VT/VF/Unknown
shockable
3831 (7.5) 1233 (15.4) 9 (4.1) 555 (18.7) 19 (7.1) 296 (9.8) 80 (19.8)
Unknown unshockable 13889 (27.0) 251 (3.1) 82 (37.1) 24 (0.8) 2 (0.7) 23 (0.8) 6 (1.5)
Asystole 26009 (50.6) 4487 (56.2) 54 (24.4) 1586 (53.3) 105 (39.2) 1716 (56.8) 282 (69.6)
PEA 7601 (14.8) 1132 (14.2) 4 (1.8) 805 (27.1) 24 (9.0) 561 (18.6) 37 (9.1)
Unknown 51 (0.1) 887 (11.1) 72 (32.6) 5 (0.2) 118 (44.0) 427 (14.1) 0 (0)

24. Characteristics (n, %)
Japan
(n=51381)
Korea
(n=7990)
Malaysia
(n=389)
Singapore
(n=3025)
Thailand
(n=573)
Taiwan
(n=3023)
UAE
(n=405)
Bystander CPR # 19176
(40.2)
2671
(42.4)
81
(22.6)
677
(24.3)
83
(15.8)
504
(19.8)
41
(10.5)
Bystander AED applied #
190
(0.5)
118
(1.9)
15
(4.8)
55
(2.0)
6
(2.0)
Not
Available
16
(4.1)
Public Access Defibrillation#
313
(0.7)
22
(0.3)
Not
Available
29
(1.1)
1
(0.3)
Not
Available
3
(0.8)
Etiology of cardiac arrest
Trauma
7495
(14.6)
718
(9.3)
20
(5.9)
99
(3.3)
77
(22.2)
228
(7.8)
13
( 3.2)
Presumed cardiac etiology
29932
(58.3)
5605
(72.7)
285
(84.1)
2253
(74.5)
189
(54.5)
2384
(81.1)
362
(89.4)
Respiratory
2293
(4.5)
65
(0.8)
15
(4.4)
240
(7.9)
47
(13.5)
192
(6.5)
4
( 1.0)
Drowning
308
(0.6)
91
(1.2)
3
(0.9)
22
(0.7)
5
(1.4)
14
(0.5)
11
( 2.7)
Other
11352
(22.1)
1230
(16.0)
16
(4.7)
411
(13.6)
29
(8.4)
120
( 4.1)
15
( 3.7)

25. Time Intervals (minutes)
Japan
(n=51381)
Korea
(n=7990)
Malaysia
(n=389)
Singapore
(n=3025)
Thailand
(n=573)
Taiwan
(n=3023)
UAE
(n=405)
Time of call to
Time arrival at
scene
(Response Time)
Mean(SD) 6.5 (3.1) 6.5 (4.3) 19.8 (12.3) 8.5 (3.9) 11.5 (6.0) 5.9 (3.1) 10.1 (5.0)
Median
(IQR)
6.0
(5.0, 8.0)
6.0
(5.0, 7.0)
17.4
(12.0, 24.2)
7.9
(5.9, 10.3)
11.3
(7.0, 15.3)
5.1
(4.1, 7.0)
9.0
(7.0, 12.0)
Time arrival at
scene to Time
leave scene
(Scene Time)
Mean(SD) 15.4 (7.3) 8.0 (9.0) 20.4 (15.3) 14.6 (4.9) 15.4 (13.3) 13.6 (9.9) 13.3 (7.1)
Median
(IQR)
14.0
(11.0, 19.0)
7.0
(5.0, 10.0)
15.8
(9.0, 27.5)
14.1
(11.6, 17.2)
10.0
(5.0, 24.3)
13.0
(10.0, 16.3)
12.0
(8.0, 17.0)
Time leave
location to Time
arrival at ED
(En-route Time)
Mean(SD) 7.3 (4.7) 7.4 (8.0) 11.1 (7.5) 10.8 (5.0) 14.2 (9.1) 4.6 (5.2) 12.2 (7.5)
Median
(IQR)
6.0
(4.0, 9.0)
6.0
(5.0, 9.0)
10.0
(6.0, 15.0)
10.0
(7.0, 13.9)
12.3
(8.0, 20.0)
4.0
(2.6, 5.1)
10.0
(7.0, 15.0)
Time of call to
Time arrival at
ED
Mean(SD) 33.3 (12.9) 21.9 (13.3) 42.8 (21.9) 33.9 (8.0) 41.5 (20.6) 24.1 (11.1) 35.5 (11.5)
Median
(IQR)
31.0
(26.0, 38.0)
21.0
(17.0, 25.0)
40.0
(28.0, 53.0)
33.2
(28.4, 38.5)
40.0
(25.0, 56.5)
23.0
(19.3, 27.0)
34.0
(28.0, 42.0)

26. Japan
(Tokyo,
Aichi,
Osaka)
Korea
(Seoul)
Malaysia
(Kuala Lumpur,
Kota Bahru,
Penang)
Singapore
Thailand
(Bangkok,
Songkla)
Taiwan
(Taipei)
UAE
(Dubai)
Overall
Total population coverage 29,582,011 10,249,679 3,760,439 5,076,700 2,576,384 2,650,968 2,003,170 55,899,351
Total number of all cases 51381 7990 389 3025 573 3023 405 66786
Total number of EMS cases 51381 7990 343 2960 299 3023 405 66401
Utstein (%)
Total 2199 669 5 322 11 122 46 3374
Incidence rate per 100 000 7 7 0 6 0 5 2 6
EMS ROSC 772 (35.1) 154 (23.0) Nil 36 (11.2) 1(9.1) 38 (31.1) 6 (13.0) 1007(29.8)
ED ROSC
Not
Available
294 (43.9) 1(20.0) 98 (30.4) 1(9.1) 62 (50.8) 9 (19.6) *465 (13.8)
Survived to admission
1 #374 (17.0) 290 (43.3) Nil 84 (26.1) 1(9.1) 29 (23.8) 10 (21.7) #788 (23.4)
Survived to discharged /
Alive at 30th day post
arrest
1
686 (31.2) 206 (30.8) Nil 37 (11.5) Nil 29 (23.8) 7 (15.2) 965 (28.6)
Post Arrest CPC 1/2
1
463 (21.1) 122 (18.2) NA 23 (7.1) NA 21 (17.2) 7 (15.2) 636 (18.9)
1
Not include transferred to another hospital
*Data not available from Japan
# Data not available from Tokyo and Aichi

27. Japan
(Tokyo,
Aichi,
Osaka)
Korea
(Seoul)
Malaysia
(Kuala Lumpur,
Kota Bahru,
Penang)
Singapore
Thailand
(Bangkok,
Songkla)
Taiwan
(Taipei)
UAE
(Dubai)
Overall
Total population coverage 29,582,011 10,249,679 3,760,439 5,076,700 2,576,384 2,650,968 2,003,170 55,899,351
Total number of all cases 51381 7990 389 3025 573 3023 405 66786
Total number of EMS cases 51381 7990 343 2960 299 3023 405 66401
All Resuscitation Attempted Arrests (%)
Total 51381 7537 217 2960 235 2998 405 65733
Incidence rate per 100 000 174 74 6 58 9 113 20 118
EMS ROSC 4397 (8.6) 366 (4.9) 9 (4.1) 149 (5.0) 41(17.4) 376 (12.5) 15 (3.7) 5353 (8.1)
ED ROSC
Not
Available
2652 (35.2) 17 (7.8) 773 (26.1) 66 (28.1) 896 (29.9) 24 (5.9) *4428 (6.7)
Survived to admission
1 #3644 (7.1) 1582 (21.0) 15 (6.9) 494 (16.7) 55 (23.4) 178 (5.9) 32 (7.9) #6000 (9.1)
Survived to discharged /
Alive at 30th day post
arrest
1
2677 (5.2) 706 (9.4) 5 (2.3) 88 (3.0) 7 (3.0) 176 (5.9) 13 (3.2) 3672 (5.6)
Post Arrest CPC 1/2
1
1436 (2.8) 235 (3.1) Not Available 49 (1.7) 4 ( 1.7) 90 (3.0) 12 (3.0) 1826 (2.8)
1
Not include transferred to another hospital
*Data not available from Japan
# Data not available from Tokyo and Aichi

28. * Excluded witnessed arrest by EMS and missing data #Data not available from Tokyo and Aichi
Sites
Mean
age (SD)
Male
*Bystander
CPR
performed
*Bystander
defibrillation
Witnessed
arrest by
Bystander
1st arrest
rhythm
VF/VT
Survived to
hospital
admission
Survived to
hospital
discharge
CPC
score
1 or 2
Survived to
discharge
(Utstein)
CPC
score
1 or 2
(Utstein)
Japan
(Aichi/
Osaka/
Tokyo)
n=51,381(%)
71.7
(18.4)
29,760
(57.9)
19,176
(40.2)
313
(0.7)
17,221
(33.5)
3,831
(7.5)
n=13,339#
3,644
(27.3)
2,677
(5.2)
1,436
(2.8)
686
(31.2)
463
(21.1)
Korea
(Seoul)
n=7,990(%)
63.5
(19.0)
5,243
(65.6)
2,671
(42.4)
22
(0.3)
3,144
(46.5)
1,233
(15.4)
1,593
(20.4)
712
(8.9)
238
(3.0)
206
(30.8)
122
(18.2)
Malaysia
(Pinang/
Kota Bahru/
Klang Valley)
n=389(%)
57.0
(17.0)
276
(71.0)
84
(22.6)
Not
Available
183
(47.0)
9
(4.1)
31
(8.0)
5
(1.3)
Not
Available
NIL NA
Singapore
n=3,025(%)
63.5
(18.2)
1,988
(65.7)
677
(24.3)
29
(1.1)
1,483
(49.0)
555
(18.7)
514
(17.0)
94
(3.2)
52
(1.7)
37
(11.5)
23
(7.1)
Thailand
(Bangkok/
Songkla)
n=573(%)
55.7
(22.1)
367
(64.0)
83
(15.8)
1
(0.2)
373
(65.1)
19
(7.1)
159
(27.7)
32
(6.8)
10
(1.7)
NIL NA
Taiwan
(Taipei)
n=3,023(%)
70.5
(18.6)
1,936
(64.0)
504
(19.8)
Not
Available
630
(22.1)
296
(9.8)
179
(5.9)
177
(5.9)
91
(3.0)
29
(23.8)
21
(17.2)
UAE
(Dubai)
n=405(%)
49.7
(18.3)
335
(82.7)
41(10.5) 3 (0.8)
186
(45.9)
80
(19.8)
32
(7.9)
13
(3.2)
12
(3.0)
7
(15.2)
7
(15.2)

29. Future Plans
New PAROS
Applicants: China,
Indonesia,
Pakistan,
Phillipines, Qatar

30. International Multi-Center
Controlled Trial of Dispatcher-
Assisted Cardio-Pulmonary
Resuscitation Intervention
Package
Pan-Asian Resuscitation Outcomes
Study Phase 2

31. Dispatcher Assisted First REsponder
Program (DARE)
21/6/2014 31

32. Pan-AsianResuscitationOutcomesStudyPhase2
Out-of-Hospital Cardiac Arrest Presenting to the
EMS Dispatch in the Asia Pacific
Sites
Phase 1 ‘historical’ data (2009-
2011)/minimum 6 months ‘run-
in’ period before implementation
Sites
Phase 1 ‘historical’ data (2009-2011)/minimum 6
months ‘run-in’ period before implementation
Sites Not Implementing Dispatcher-
assisted Cardiopulmonary Resuscitation
Sites Implementing Dispatcher-assisted
Cardiopulmonary Resuscitation
(Intervention)
Phase 1 ‘historical’
data
Collection of Out-of-Hospital Cardiac Arrest and
Dispatcher CPR data
Basic Package Implemention
 Dispatcher-CPR
protocol
 Training program
Comprehensive Package Implemention
 Dispatcher-CPR protocol
 Training program
 Quality measurement tool
 Quality Improvement Program
 Community Education Program
Collection of Out-of-
Hospital Cardiac
Arrest data only

33. Survival to hospital discharge for Asia
remains relatively low compared to North
America and some European countries.
This large population-based registry will
provide a baseline to measure the effect of
subsequent interventions such dispatcher-
assisted CPR and PublicAccess Defibrillation
in this region.

34. Thank you