Validation of the new Vancouver Chest Pain Rule in Asian chest pain patients presenting at the emergency department.

Objectives: The new Vancouver Chest Pain (VCP) Rule recommends early discharge for chest pain patients who are at low risk of developing acute coronary syndrome (ACS), and thus can be discharged within 2 hours of arrival at the emergency department (ED). This study aimed to assess the performance of the new VCP Rule for Asian patients presenting with chest pain at the ED.

Methods: This prospective cohort study involved patients attended to at the ED of a large urban centre.

Reducing ambulance response times using geospatial-time analysis of ambulance deployment.

Objectives: This study aimed to determine if a deployment strategy based on geospatial-time analysis is able to reduce ambulance response times for out-of-hospital cardiac arrests (OOHCA) in an urban emergency medical services (EMS) system.

Methods: An observational prospective study examining geographic locations of all OOHCA in Singapore was conducted. Locations of cardiac arrests were spot-mapped using a geographic information system (GIS).

Geographic-time distribution of ambulance calls in Singapore: utility of geographic information system in ambulance deployment (CARE 3).

Introduction: Pre-hospital ambulance calls are not random events, but occur in patterns and trends that are related to movement patterns of people, as well as the geographical epidemiology of the population. This study describes the geographic-time epidemiology of ambulance calls in a large urban city and conducts a time demand analysis. This will facilitate a Systems Status Plan for the deployment of ambulances based on the most cost effective deployment strategy.

Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Singapore.

Objective: Chest compression only cardiopulmonary resuscitation (CC-CPR) without ventilation has been proposed as an alternative to standard cardiopulmonary resuscitation (CPR) for bystanders. However, there has been controversy regarding the relative effectiveness of both of these techniques. We aim to compare the outcomes of cardiac arrest patients in the cardiac arrest and resuscitation epidemiology study who either received CC-CPR, standard CPR or no bystander CPR.

Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial.

Objective: To investigate whether antenatal breast feeding education alone or postnatal lactation support alone improves rates of exclusive breast feeding compared with routine hospital care.

Design: Randomised controlled trial.

Setting: A tertiary hospital in Singapore.

Comparison of termination-of-resuscitation guidelines for out-of-hospital cardiac arrest in Singapore EMS.

Context: Termination of resuscitation (TOR) in the field for out-of-hospital cardiac arrest (OHCA) can reduce unnecessary transport to hospital and increase availability of resources for other patients.

Objectives: To compare the performance of three TOR guidelines for Basic Life Support-Defibrillator (BLS-D) providers when applied to cardiac arrest patients in the Cardiac Arrest and Resuscitation Epidemiology (CARE) study.

Design: This prospective cohort study involved all OHCA patients attended by BLS-D providers in a large urban center.

Survival outcomes with the introduction of intravenous epinephrine in the management of out-of-hospital cardiac arrest.

Study Objective: The benefit of epinephrine in cardiac arrest is controversial and has not been conclusively shown in any human clinical study. We seek to assess the effect of introducing intravenous epinephrine on the survival outcomes of out-of-hospital cardiac arrest patients in an emergency medical services (EMS) system that previously did not use intravenous medications.

Methods: This observational, prospective, before-after clinical study constitutes phase II of the Cardiac Arrest and Resuscitation Epidemiology project.