Speech By Dr Lam Pin Min, Minister Of State For Health, at The International Resuscitation Science Symposium Opening Ceremony, 27 February 2016

Professor Ivy Ng, Group CEO, SingHealth

Associate Professor Lim Swee Han, President, Society for Emergency Medicine in Singapore and Chairman, Resuscitation Council of Asia

Dr Lim Jia Hao, Co-Chairman, International Resuscitation Science Symposium

Professor Vinay Nadkarni, Co-Chair, International Liaison Committee on Resuscitation

Professor Gavin Perkins, Co-Chair, International Liaison Committee on Resuscitation

Distinguished Guests

Ladies and Gentlemen

Good morning.

1             It is my pleasure to join you this morning at the 2^nd International Resuscitation Science Symposium, held in conjunction with the Society for Emergency Medicine in Singapore’s Annual Scientific Meeting. It is a privilege for Singapore to host this event and welcome international representatives of resuscitation organisations to our country.  

2             Medical resuscitation is very time-sensitive, and the stakes are high. The difference between life and death lies in minutes. Effective and standardised practices have a significant impact on patients’ survival. Hence, scientists and doctors constantly do research, evaluate and review current practices to improve care and outcomes. To ensure standardised and up-to-date resuscitation and cardiac care practices, the Consensus on Cardiopulmonary Resuscitation and Emergency Cardiac Care Science and Treatment Recommendations by the International Liaison Committee on Resuscitation (ILCOR) is revised every five years, with the latest revision being in 2015. These recommendations play a pivotal role in guiding Resuscitation Councils worldwide as they develop the latest guidelines relevant to their respective healthcare systems. 

3             The new ILCOR recommendations focus on improving neurological and survival outcomes of cardiac arrest patients by enhancing post-resuscitation care in the hospitals. Greater emphasis will be placed on instituting targeted temperature management for at least 24 hours as well as administering emergency percutaneous coronary intervention in a timely fashion, as the standard of care.

Developing Capabilities of Emergency Medicine Healthcare Professionals

4             Singapore has come a long way since Emergency Medicine was first introduced in Singapore 65 years ago as a medical specialty. Today, all our public acute hospitals provide 24-hour accident and emergency services, led by well-trained emergency medicine physicians.

5             We currently have more than 127 specialist-registered Emergency Physicians, with another 97 in training. This pool of emergency medicine specialists will be needed as we build two new acute hospitals - Sengkang General Hospital and Woodlands General Hospital – in the coming years. Besides medical specialists, there are also emergency medicine trained nurses working alongside doctors to deliver high quality emergency care. Education institutions such as the SingHealth Alice Lee Institute of Advanced Nursing and SGH’s Institute of Medical Simulation and Education offer team-based simulation training that allows practitioners to keep up with new developments and hone their skills as teams in safe and realistic settings. Every year, these two institutes train more than 2,000 local and overseas emergency medicine practitioners to equip them with the latest skills and knowledge.

Improving Pre-hospital Emergency Care

6             Good emergency medicine care begins with a robust pre-hospital emergency care system. Formed in 2010, the Pan-Asian Resuscitation Outcomes Study (PAROS) clinical research network, chaired by SGH emergency medicine physician Associate Professor Marcus Ong, looked at deployable interventions and strategies to improve survival for patients who suffer out-of-hospital cardiac arrest. This network comprises of pre-hospital care experts and emergency medicine physicians from across 13 countries, including South Korea, Japan, Malaysia and Thailand.

7             At the national level, the Ministry of Health works closely with the Ministry of Home Affairs on nation-wide initiatives to improve pre-hospital care. Some examples include emergency medicine nurses assisting at the Singapore Civil Defence Force (SCDF) call centre to improve call-triage capabilities, and introducing SCDF’s dispatcher phone-assisted CPR to guide the layperson to improve CPR performance on site. I am heartened that the research efforts have been translated into practical interventions to deliver appropriate and timely care for our patients.

Engaging the Community

8             To enable more lives to be saved, we need the participation of the general public in pre-hospital emergency care. Every year, about 1,800 people collapse and die from cardiac arrest in Singapore, before paramedics arrive. When emergencies occur, those in the best position to initiate the first line of care and render life-saving aid are the bystanders. But it is estimated that only 22 per cent of bystanders perform CPR on a cardiac arrest victim, even when six out of 10 of such incidents occur in the presence of family, friends or colleagues. We can improve the survival outcomes of a collapsed patient should CPR be administered before the arrival of Emergency Medical Services provider.

9             Based on the latest ILCOR recommendations, the National Resuscitation Council of Singapore will be advocating the training of lay persons in compressions-only CPR.  This recommendation is also supported with data from a local study done by Singapore General Hospital and National Heart Centre Singapore, which showed that lay person with training in chest-compression-only CPR gave better quality chest compressions than those who underwent standard training, consisting of chest compressions and ventilation.

10          MOH and SCDF have been working with community partners, such as schools, People’s Association and the Singapore Heart Foundation to increase the awareness of CPR amongst the general public. The Dispatcher Assisted First Responder Programme, or DARE, is one such programme where members of the public are taught chest-compression only CPR. Since 2014, the programme has trained more than 20,000 participants, including students and members of the public.

11          The Citizen First-Responder Training Programme, launched recently by the National Resuscitation Council of Singapore and the National First-Aid Council, also allows the public to be trained and certified in first-aid. We will continue to ramp up efforts to engage the community, and prepare them for the unexpected event of a cardiac arrest, so that everyone can play a part to save someone in need.

Conclusion

12          I am heartened to see so many emergency care practitioners from various professional groups, both local and international, gathered at this symposium. By learning from one another, and collaborating and sharing best practices, we can harness our collective wisdom to address common challenges faced in the field of emergency medicine.  This will definitely allow us to raise the standards of emergency care and advance resuscitation science to benefit our patients. On this note, I wish you all a fruitful Symposium.

Thank you.