CARInG, a research and capacity building initiative around cardiac arrests has been launched by the Aga Khan University in partnership with six hospitals in Karachi, as well as local emergency response providers.
A cardiac arrest is an unexpected, abrupt disruption to the heart’s operation which often causes sudden death. Since the majority of cardiac arrests in Pakistan take place before patients can reach hospital, only 1 to 3 percent, survive.
CARInG, the Cardiac Arrest Resuscitation Interest Group, is looking to change the situation. The project seeks to generate life-saving knowledge by using data from the city’s emergency departments to create a registry of patients who have suffered cardiac arrest. This information will be analysed to assess whether patients received various life-saving measures (such as CPR or defibrillation) at home, en route to the hospital, or in the emergency room.
By assessing the effectiveness of each step in the ‘chain of survival’ (the sequence of critical actions to treat life-threatening emergencies) researchers aim to pinpoint how to improve survival rates from cardiac arrests.
“Few ambulances in the city have access to life-saving facilities and only a small number of people in Karachi have formal training in CPR. These are just some of the factors that result in delays and errors in providing the critical treatment that such patients need. Through our research we hope to identify the areas where care can be most effective and to then build capacity in that area,” said Munawar Khursheed, associate professor of emergency medicine at AKU.
AKU researchers have already gathered the treatment history of over 500 cardiac arrest patients from four hospitals in the city: Jinnah Postgraduate Medical Centre, Karachi Institute of Heart Diseases, Aga Khan University Hospital and Tabba Heart Institute. Data will now be gathered from three more hospitals in the city: Patel Hospital, Abbasi Shaheed Hospital and the National Institute for Cardiovascular Diseases to provide a more detailed picture of the challenge posed by cardiac arrests. Other hospitals have also been asked to take part in the study.
CARING also seeks to put in place proven initiatives that can tackle the problem of out-of-hospital cardiac arrests. Timely CPR has been found to significantly improve the chances of surviving a cardiac emergency. This component of CARING will see AKU faculty work with private and public sector organisations to provide CPR training for school students and emergency medical staff.
Expanding access to first responders is another objective and a mobile application will also be developed to enable quick contact with nearby CPR-trained individuals in emergencies.
CARING’s objectives are in line with global efforts to achieve targets under
goal 3 of the Sustainable Development Goals: ensure healthy lives and promote well-being for all at all ages. Target 3.4.1 of the goal calls for special efforts to reduce premature deaths caused by cardiovascular conditions by a third by 2030.
The research and capacity building initiatives under CARInG are funded by the
Singapore Clinical Research Institute. Other institutions involved with CARInG include First Response Initiative Pakistan, Humanity Initiative, HOPES, Saving 9, Clinic 5 and the Aman Foundation.