Michigan State University

College of Osteopathic Medicine

Global Cardiovascular Health

An out-of-hospital cardiac arrest (OHCA) is defined as cessation of cardiac mechanical activity that is confirmed by the absence of signs of circulation and that occurs outside of a hospital setting. Interventions to improve survival for OHCA patients include bystander and Emergency Medical Services (EMS) cardiopulmonary resuscitation (CPR), implementing Community Public Access Defibrillation (PAD) programs, and facilitating pharmacological and other resuscitative measures performed by EMS personnel or by doctors and nurses at the receiving hospital. The probability of surviving an OHCA (9.1% survival to hospital discharge in U.S.) can increase significantly, if EMS paramedics or bystanders immediately intervene in a sequence of actions called the “chain of survival.” Urgent actions include:

  1. Rapid EMS activation by calling the appropriate emergency response number
  2. Immediate initiation of cardiopulmonary resuscitation (CPR)
  3. Rapid use of a defibrillator where required
  4. Rapid delivery of advanced life support by EMS personnel
  5. Early post-resuscitative care. Improvements in pre-hospital care and emergency care systems have the capacity to save the lives of patients suffering a cardiac emergency.

The OHCA survival rates are much lower in developing countries. The Pan Asia Resuscitation Outcomes Study (PAROS) reported survival to hospital discharge rates of 0.5–8.5% in Asian countries. Dr. Irfan has previously worked on OHCA in Qatar and is currently working with colleagues in South Africa, Botswana, and Pakistan on OHCA epidemiology and improving outcomes by strengthening health systems.

Publications

  • Irfan FB, Consunji RIGDJ, Peralta R, El-Menyar A, Dsouza LB, Al-Suwaidi JM, Singh R, Castrén M, Djärv T, Alinier G. Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar. Int J Emerg Med. 2022 Sep 16;15(1):52.
  • Irfan FB, Castren M, Bhutta ZA, George P, Qureshi I, Thomas SH, Pathan SA, Alinier G, Shaikh LA, Suwaidi JA, Singh R, Shuaib A, Tariq T, McKenna WJ, Cameron PA, Djarv T. Ethnic differences in out-of-hospital cardiac arrest among Middle Eastern Arabs and North African populations living in Qatar. Ethn Health. 2021 Apr;26(3):460-469.
  • Bhutta ZA, Qureshi I, Shujauddin M, Thomas SA, Masood M, Dsouza LB, Iqbal N, Irfan FB, Pathan SA, Thomas SH. Characterizing Agreement in the Level of Interarm Blood Pressure Readings of Adults in the Emergency Department (CALIBRATE Study). Qatar Med J. 2020 May 4;2020(1):14.
  • Irfan FB, Consunji R, El-Menyar A, George P, Peralta R, Al-Thani H, Thomas SH, Alinier G, Shuaib A, Al-Suwaidi J, Singh R Castren M, Cameron PA, Djarv T, Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar: A nationwide population-based study. Int J Cardiol. 2017 Aug 1;240:438-443.
  • Akhtar N, Salam S, Kamran S, Bourke P, Joseph S, Santos M, Khan R, Irfan F, Deleu D, Malik RA, Shuaib A. Ethnic variation in acute cerebrovascular disease: Analysis from the Qatar stroke registry. European Stroke Journal. 2016;1(3):231-241.
  • Irfan FB, Bhutta ZA, Castren M, Straney L, Djarv T, Tariq T, Thomas SH, Alinier G, Al Shaikh L, Owen RC, Al Suwaidi J, Shuaib A, Singh R, Cameron PA. Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study. Int J Cardiol. 2016 Aug 24; 223:1007-1013.
  • Haq FU, Jalil F, Hashmi S, Jumani MI, Imdad A, Jabeen M, Hashmi JT, Irfan FB, Imran M, Atiq M. Risk factors predisposing to congenital heart defects. Annals of Pediatric Cardiology 07/2011; 4(2):117-21.