1. National Cardiac Arrest Surveillance Division of Chronic Disease Control, The Korea Centers for Disease Control and Prevention

2. Background Lower survival rates than its occurrences Absence of representative national data Lack of nationwide evaluation on EMS – Need to establish outcome measures on the EMS infrastructure – Need to establish survival improvement measures through government interventions

3. Objective Develop sustainable surveillance system to monitor incidence, action and survival rate in sudden cardiac arrest Evaluate its action effects Continuous production of national level of health indicators (incidence, survival rate etc.)

4. History Nationwide Cardiocerebrovascular Disease Prevention Measure Plan (‘06.6.9) Cardiac Arrest Surveillance Pilot Study (‘08.1~3) – Seoul, Incheon, Jeju KCDC and NEMA MOU (’08.6.17) Expansion of Cardiac Arrest Surveillance to entire country (’08.11~’09.3) Hospital-based Cardiovascular Disease Surveillance System Symposium (‘09.9.24)

5. History National Cardiac Arrest Surveillance Advisory Committee (‘11.4) –Consultant and development of methods and policy National approval for statistics (‘11.9.29) 1 st Cardiac Arrest Surveillance Symposium (‘12.7.24) Cardiac Arrest Related Epidemiologic Seminars (‘12.~) Cardiovascular Disease Researcher Discussion Meeting (‘13.2.20) 2 nd Cardiac Arrest Surveillance Symposium (‘13.6.19)

6. Sources of Data EMS Dataset – 17 State Emergency Management Agencies – Out-of-Hospital Cardiac Arrest cases transported by Emergency Medical Service (119 call centers) Cardiac arrest or respiratory arrest cases CPR or AED treated Hospital Dataset (Medical Records) – 650 participated hospitals – Cardiac arrest related information (survival status, in- hospital treatments, etc)

7. Outcomes Indicators Regional level, EMS level, Hospital level three province 23 core indicators & 24 additional indicators standardized incidence rate, CPR service pro- portion, Survival discharge pro-portion, cerebral performance category pro-portion etc

8. Public-Private Co-Surveillance System National Emergency Management Agency 구급대원 업무 품질관리 구급일지 제출 구급대원 성과지표 자료제공 ( 조사결과 ) Data registration system 의무기록 DB 구축 Si-Do, Si-Gun-Gu Hospitals 파견조사 협조 의무기록조사 수행 병원 성과지표 결과 환류 Ministry of Health & Welfare Advisory Committee 보건복지부, 관련 학회, 협회, 시민단체 등 17 Regional fire department Korea Centers for Disease Control & Prevention

9. Main Result

10. Standardized Incidence Rate

11. Trends of national survival discharge rate

12. Survival discharge rate by Province

13. Trends of Survival admission·discharge rate

14. ※ Sasson C et al. Circ Cardiovasc Qual outcomes. 2010;3:63-81 1.0 1.5 2.5 Dispatcher assisted CPR Bystander CPR No CPR Changes of Survival rate from executing CPR

15. Witnessed mainly by layperson such as family, neighbors ※ National Sudden Cardiac Arrest Surveillance, KCDC, 2012

16. Development of Guideline for Citizen’s Action to Sudden Cardiac Arrest – Development of Simple 3-step Protocol (Wake, Call, Compress) – Introduced at the 1 st Cardiac Arrest Surveillance Symposium Survey on the current situation of CPR and recognition of cardiac arrest on Korean workers – Set nationwide database Activities & Plans for Improving Survival Rate (1)

17. Develop standard training program for CPR – Basic Level: compulsory education, citizen who never received CPR training, refresher course – Further Level: volunteer citizens for further training, Primary responders specified in the Act on Emergency Medical – main content: education program with training materials(video, instructor’s guideline and training book) Activities & Plans for Improving Survival Rate (2)

18. Build pubic partnership to activate dissemination Strengthening high quality education through periodic evaluation Available website – www.cdc.go.kr www.cdc.go.kr – Http://ccvd.cdc.go.kr Http://ccvd.cdc.go.kr – www.youtube.com (By searching “ 표준 심폐소생술 ”) www.youtube.com Activities & plans for improving survival rate(3)

19. Development of standardized educational program for hospital provider for improving survival of cardiac arrest – Develop educational PPT and protocol for trainers (2012) – Evaluate trainees knowledge level – Pilot studies: 3 regions (total 6 times) -2013 18 EMS MDs and 18 nurses Activities & plans for improving survival rate(4)

20. Future Plans 1.Development of Bystander CPR Educational Program Particularly focusing on foreign workers and intermarriage families Translation of CPR Educational Program (video, instructor’s guideline and training book) into 9 languages (English, Japanese, Chinese, Vietnamese, Filipino, Thai, Cambodian, Russian, Mongolian) and distribute them to national and local NGO agencies 2.Evaluation on CPR Education Strengthening high quality education through periodic evaluation 3.Development of Analysis Model and Validation of Follow-up Surveillance to identifying etiology of acute cardiac arrest 4.International symposium and expert meetings in 2014

21. Website : Prevention of Cardio-Cerebro- Vascular Diseases Management

22. Web based Data Registry System

23. Thank you for your attention Thank you