Position Statement
The Hong Kong College of Emergency Medicine believes that:
- Ventricular fibrillation and pulseless ventricular tachycardia constitute a significant percentage of patients in out-of-hospital cardiac arrests.
- Prior to arrival of emergency medical service (EMS) responders, immediate high-quality cardiopulmonary resuscitation (CPR) and public access defibrillation (PAD) conducted by trained non-traditional responders in the immediate few minutes of cardiac arrests will increase survival of these victims.
- At sites where security structures capable of responding to emergencies are already in place, incorporation of CPR PAD programme is a practicable way to improve survival, especially if the volume of people flow in the vicinity is high.
Ultrasound imaging has been utilized successfully in various specialties of medicine to enhance physician’s ability to evaluate, diagnose and treat patients.
The Hong Kong College of Emergency Medicine endorses the following principles:
- Emergency ultrasound examination should be available twenty-four hours a day in Emergency Departments.
- Focused ultrasound imaging by Emergency Physicians will enhance quality of care to acutely ill or injured emergency patients.
- Emergency Physicians providing ultrasound services should have appropriate training and there should be a mechanism to maintain a satisfactory standard.
- Patient with lower respiratory tract symptoms should have a chest X-ray for assessment.
- Once the diagnosis of CAP is made, the severity can be assessed by clinical features and severity scores (e.g. CRB-65, CURB-65, Pneumonia Severity Index).
- Supportive and symptomatic treatment as clinically indicated.
- Early use of antibiotic is advisable, preferably within 4 hours after diagnosis.