Out of hospital adult cardiac arrests in a university hospital in Central Saudi Arabia

To the Editor

We read with great interest the article on out of hospital cardiac arrest (OHCA) by Bin Salleeh et al.1 We commend them on the publication of this vitally important manuscript, which will add significantly to the paucity of OHCA literature from the Middle East region. As an institution in another Middle East nation, we too firmly believe McNally’s assertions that the establishment of cardiac arrest registries is paramount in order to determine each country’s baseline data, benchmark system performance, and determining patient outcomes.2 Only through measurement and subsequent analysis can we truly recommend and implement strategies to reduce mortality from OHCA.

National Ambulance LLC elected to join the Pan-Asian Resuscitation Outcomes Study (PAROS) as referenced by Berhanu.3 Pan-Asian Resuscitation Outcomes Study is an international cardiac arrest registry study with members across 10 countries including the United Arab Emirates. It is an Asia-Pacific collaborative research network that aims to inform OHCA policies and practices within member states and in the Asia-Pacific region in general. We are nearing completion of the second year of prehospital data collection, and the first full year of hospital data collection in a number of the Emirates. Our manuscript (pending), once published, and combined with the findings from Dubai as detailed recently,4 will represent the first true picture of the impact of OHCA on the majority of the United Arab Emirates (UAE) population. We have uncovered similar findings to Bin Salleeh et al1 with regards to cardiac arrest recognition, rates of bystander cardiopulmonary resuscitation and automated external defibrillators application, and rates of Emergency Medical Service activation and utilisation. Perhaps our colleagues in Saudi Arabia would consider contributing to the PAROS study in the future along with the possible establishment of not only a Saudi national registry, but perhaps collaboration on the formation of a Middle East registry?

Reply from the Author

I would like to thank Mr. Batt et al from National Ambulance LLC, Abu Dhabi, UAE for their comment on our article.1 Mr. Batt et al’s reflection and suggestion to join the PAROS is highly appreciated.1 Establishing a registry for out of hospital cardiac arrest cannot be over emphasised here.2 In the view of paucity of data from our region, all efforts should join to study this event for the best of our community. We recently published our pediatric data on the same topic,5 however, data is limited because of single site report, therefore, reporting from different sites and/or joining regional registry will add more value to the data and to the individual reporting sites too. Pan-Asian Resuscitation Outcomes Study is a well known registry in Asia and pacific area with clear objectives and organizational structure that is growing every year. However, it covers big and diverse geographical, cultural, economic, and health care systems, which represent a challenge in data collection and interpretation from such diverse areas. We will collaborate with all efforts to study out of hospital cardiac arrest nationally and internationally.

Hashim Bin Salleeh

College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia