Aim: To describe temporal trends in the incidence, characteristics and outcomes of hanging-related out-of-hospital cardiac arrest (OHCA). Method: A retrospective study of all hanging-related OHCA in Victoria, Australia, between 2000 and 2017 was conducted. Trends in incidence, characteristics and outcomes were assessed using linear regression and a non-parametric test for trend, as appropriate. Predictors of survival to hospital discharge were identified using multivariable logistic regression. Results: Between 2000 and 2017, emergency medical services (EMS)-attended 3891 cases of hanging-related OHCA, of which 876 cases (23%) received an attempted resuscitation. The overall incidence rate of EMS-attended cases was 3.8 cases per 100,000 person-years increasing from 2.3 cases per 100,000 person-years in 2000 to 4.7 cases in 2017 (p for trend <0.001). Incidence rates increased approximately two-fold in young adults (18-44 years) and three-fold in middle aged adults (45-64 years). Despite improvement in the rate of bystander cardiopulmonary resuscitation (from 49% in 2000-05 to 75% in 2012-17), the survival to hospital discharge rate remained unchanged (3% overall). Among adult survivors with 12-month follow-up, 10 of 14 patients survived to 12 months post-arrest (71%). Five patients responded to telephone interviews, of which three patients reported severe functional disability. An initial shockable rhythm (OR 23.17, 95% CI: 5.75, 93.36) or pulseless electrical activity (OR 13.14, 95% CI: 4.79, 36.03) were associated with survival. Conclusion: The incidence of hanging-related OHCA doubled over the 18 year period with no change to survival rates. New preventative strategies are needed to reduce the community burden of these events.

Background: Management of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia.Methods: Between Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed.Results: During the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3^rddegree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001).Conclusion: While the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.

Low health literacy is associated with poor health outcomes, inefficient use of healthcare resources, higher mortality risk, and increased costs. The aim of this research is to explore public awareness and preparedness regarding various treatment options for acute medical events and to assess the competence in assessing the urgency of such medical situations in 6 Middle Eastern countries namely, Jordan, Saudi Arabia, Egypt, Lebanon, Kuwait, and Bahrain. This research involved a cross-sectional survey study design to assess public knowledge and preparedness about emergency medicine using an online questionnaire distributed through accessible online channels between March 1, 2024 until September 11, 2024. A total of 4909 participants were involved in this research. The questionnaire was developed based on a thorough review of existing literature related to public knowledge and public preparedness of emergency medicine. Binary logistic regression analysis was used to identify significant predictors of insufficient and problematic emergency health literacy (EHL) levels. Overall, the most commonly known emergency care service was identifying emergency practice nearby (81.4%). The least commonly known emergency care service was identifying the rescue service (48.1%). The highest degree of difficulty reported by the study participants was the difficulties they face to evaluate when to use emergency medical services (39.6%). The mean public EHL score for the study sample was 2.77 (standard deviation [SD]: 0.44) out of 3. The mean public EHL score ranged between 2.69 (SD: 0.50) for Kuwait and 2.89 (SD: 0.56) for Bahrain. The majority of the study participants (75.1%) demonstrated problematic EHL. Males, young participants aged 24 to 30 years and elderly participants aged 61 years and older, highly educated individuals, high income level individuals, and those who work in the healthcare sector were less likely to have inadequate and problematic EHL levels (P < .05). The findings of the present study indicate limited emergency public EHL among 6 of the Middle Eastern countries, highlighting the need for interventions to promote public knowledge and capabilities. Educational campaigns that promote EHL should target females, those with low education and socioeconomic status, those in age range of 30 to 60 years, and those who do not work in health sector.