25 May 2011
WE REFER to Monday’s report (“Runner dies during 5km event”). We feel an elaboration is essential to understand the emergency response, while providing an assessment of how Singapore can further enhance emergency medical preparedness.
When the man collapsed, he was almost immediately given cardiopulmonary resuscitation (CPR) by two bystanders who happened to be doctors. The on-site medical support team was activated, while other bystanders called 995 for an ambulance.
As we had our medical team on site, a motorcycle fast-response paramedic from Hope Ambulance Service was the first to arrive at the scene. CPR was continued and two shocks were delivered with an automated external defibrillator (AED).
A Hope ambulance, which was already on site, arrived minutes later and the patient was transferred to it. A second ambulance from the Singapore Civil Defence Force (SCDF) also arrived, and the team resuscitating the patient was helped by personnel from the SCDF and Hope, who worked together in the ambulance en route to Changi General Hospital.
While in the ambulance, adrenaline (the main drug used to stimulate the heart in cardiac arrest) was administered. Two further AED shocks were delivered.
The journey out of the area was delayed by traffic congestion. The ambulance had its lights and sirens on, but there were some drivers who did not give way. We appeal to all drivers to give way to emergency vehicles. This simple act can save lives.
The organisers of the event were prepared for medical emergencies: There were advisories in publicity materials, on-site medical arrangements and volunteers trained in first aid stationed at intervals along the route. In the pre-race announcements, the emcee also advised runners who were not feeling well to refrain from participating.
Those engaging in sporting activities are advised to get an assessment by their family physician and, if deemed necessary, to go for screening tests. People who develop symptoms such as chest discomfort, chest pain, unusual shortness of breath, giddiness and fainting during even low-impact exercises should seek immediate medical attention.
Improving our out-of-hospital cardiac arrest survival rates calls for everyone to play their part, in order to strengthen our chain of survival: early access, early CPR, early defibrillation and early advanced life support care. We urge everyone to learn CPR and first aid, as medical emergencies can occur any time and anywhere.
To the family of Mr Lee Khoon Bok, our deepest condolences on the demise of your beloved husband and father. No words of comfort can replace your loss.
Associate Professor Fatimah Lateef
Senior Consultant
Dept of Emergency Medicine
Singapore General Hospital
Adjunct Associate Professor
Duke-NUS Graduate Medical School
Yong Loo Lin School of Medicine,
National University of Singapore
Dr Charles Chan Johnson
Medical Director
Hope Ambulance Service
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