SUMMARYThe results are presented of 21/2 years of experience of patients with out-of-hospital cardiac arrests who were resuscitated in an accident and emergency department (A&E) attached to an acute district hospital in Hong Kong. Out of 263 cases of out-ofhospital cardiac arrest as a result of a variety of causes only seven patients survived (3%) and among the 135 patients with cardiac aetiology only four survived (3%). Ways to improve the outcome for out-of-hospital cardiac arrest are discussed.

Background Implementation of prevention programs for bicycle safety should be based on a good understanding of the profile of bicycle accidents. The objective of this study was to investigate the differences in the severity of bicycle-related injuries when comparing with various risk factors, and to utilize this information to formulate the intervention measures. Methods A retrospective review was conducted on all patients (n=116) who were treated for bicycle-related injuries within a period of 66 days at the emergency department of a district hospital in Tai Po, New Territories. Results School-aged children, especially boys, were more commonly injured. The head and lower extremities were the common sites of injuries. Female gender (χ2=4.39; P<0.05) and injuries involving head and upper extremities (χ2=12.61; P<0.05) were associated with higher chance of serious injury. Conclusion Tai Po district had a high incidence of bicycle accidents due to its geographical location. Population at a greater risk for bicycle injury was the male gender school-aged children and therefore prevention program should be targeted at them.

Introduction: Pulse oximetry measures arterial oxygen saturation and was introduced into the clinical field since the 1980s. It provides a simple, portable, non-invasive and inexpensive way for monitoring blood oxygen saturation. Previous studies demonstrated that most hospital staff had limited knowledge on the correct use of pulse oximetry and what might affect the readings. This study aimed at evaluating the extent of knowledge in pulse oximetry among the clinical staff of an emergency department. Method: A 25-item multiple-choice type questionnaire was given to the medical and nursing staff of the Accident and Emergency Department (AED) of the Alice Ho Miu Ling Nethersole Hospital. In addition to demographic information, respondents were required to answer questions relating to the basic principles of pulse oximetry, recognition of physiological factors limiting its accuracy and management regarding hypothetical scenarios. The scores were expressed and analysed on a scale of 0-100. Results: A total of 44 questionnaires were completed by 27 nurses and 17 doctors with their test scores ranging from 20 to 72 (median=46). Doctors (median=56) did better than nurses (median=44) in general (P=0.036) but this advantage, however, did not apply to questions on hypothetical scenarios where nurses performed better on the contrary. Correlation analysis proved that there was no linear relationship between respondents' test scores and their years of clinical experience (r=0.051, Spearman). This absence of linear relationship also applied to individual doctors (r=0.244, Spearman) and nurses groups (r=0.162, Spearman). Conclusion: There was insufficient knowledge on the use of pulse oximetry among staff of the AED. The level of understanding did not correlate with their clinical experience. Training programs targeting both the fresh and the experienced staff are recommended.(Hong Kong j.emerg.med.

Transport kit is a key element to ensure safe inter-facility transport (IFT). The kit was generally reported by transport staff to be heavy and inconvenient in accessing the required items. Objective: This study aimed at evaluating the outcome and the feedback from emergency nurses on the use of a new and lighter nurse-led transport kit (NLTK) in IFT. Methods: A cross sectional study was carried out in two Accident and Emergency Departments in Hong Kong from 1st January 2008 to 31st March 2008. All cases involving nurse-led IFT were included into the study. Questionnaires for assessing the rating of satisfaction were distributed to the staff after every mission. Results: Eighty-four questionnaires were returned with a response rate of 80.8%. The overall rating on satisfaction before and after the use of NLTK was 14.6±3.0 and 19±3.2 respectively (mean±SD) with statistically significant improvement in terms of its weight, convenience and spaciousness of kit (p<0.05). Conclusion: The new NLTK is more user-friendly than the traditional kit in nurse-led IFT.