President's Message

Dear Members of the Hong Kong Society for Emergency Medicine and Surgery,

Out-of-hospital cardiac arrest (OHCA) remains one of the leading causes of sudden death in Hong Kong. Each year, approximately 6,000 OHCA cases occur locally, yet the 30-day survival rate is extremely low—around 2.3%, and only 1.5% of patients are discharged with good neurological function ^1,2,3. These figures remind us that the “golden three to five minutes” after collapse are decisive. Early defibrillation makes a significant difference between life and death; it is vital to focus our attention on a simple yet powerful life-saving measure: promoting the public’s use of automated external defibrillators (AEDs) and strengthening community first-aid capability. 

The evidence is clear: early defibrillation works. Research has shown that survival rates for cardiac arrest can improve dramatically—sometimes reaching upwards of 25%—when CPR and AEDs are applied promptly by bystanders. However, the gap between the availability of this intervention and its actual utilization remains wide. While programs like the Fire Services Department’s "AED Anywhere for Anyone" have made commendable strides in increasing the number of registered AEDs in public spaces, we are still facing profound systemic and social obstacles.

What are these hurdles? Firstly, there is an accessibility gap. Many AEDs are located in buildings or venues that are not accessible 24/7, limiting their utility to office hours only. Secondly, there is a psychological and training barrier. Public surveys consistently reveal that despite high levels of willingness to call for help, many citizens lack the confidence to use an AED. A Hong Kong study ⁴ in 2024 conclude that only 44.8% and 47.8% of respondents who were willing to perform CPR and use AED, respectively. Young adults aged 18–25 years demonstrated the lowest willingness to perform CPR. Common concerns include the fear of causing injury, misconceptions that only "certified" medical professionals should touch the devices, and an overarching, often unfounded, fear of legal repercussions etc.

The following measures can be considered to bridge the gap;

Advocacy for "Heart-Safe" Environments: To push for the placement of AEDs in truly high-traffic, 24-hour accessible locations, and advocate for standardized signage that makes these life-saving tools as recognizable as fire extinguishers.

Demystifying AED Use: The promotion of the fact that modern AEDs are designed for the layperson, with intuitive voice prompts that guide the user safely. We need to normalize the "Anyone can use an AED" culture to combat the fear of intervention.

Educational Outreach: By supporting community training initiatives—particularly in schools and workplaces—we can turn bystanders into active, confident lifesavers.

Saving a life begins long before the ambulance arrives. By championing wider accessibility and public confidence, we are not just practicing medicine; we are empowering the community to be our partners in survival.

Together, we can make the “final mile” of emergency response a true bridge to survival. Wishing you all good health and continued dedication.

Warm regards,

Dr Wendy Cheng

President

Hong Kong Society for Emergency Medicine and Surgery

References

1.    Hung FH. HKFSD placed AED in the community anyone can save alife [translated from Chinese] Hk01; 2021.

2.    Hong Kong Fire Services Department. Hong Kong fire services department review 2019

3.    Fan KL, Leung LP, Siu YC. Out-­ of-­ hospital cardiac arrest in Hong Kong: a territory-­ wide study. Hong Kong Med J 2017;23:48–53.

4.    Tam VCW, Kwok AWL. BMJ Public Health 2024;2:e000406. doi:10.1136/bmjph-2023-000406