The survival rate for non-traumatic out-of-hospital cardiac arrest in Hong Kong is low (1.25%-1.6%). Despite the reduced time interval between call receipt and first defibrillatory shock to 11.12 minutes during the past decade, the time interval between collapse/recognition and first defibrillatory shock, at 14.25 minutes, is too long. Studies of out-of-hospital cardiac arrest performed in Hong Kong were reviewed to ascertain whether a public access defibrillation programme can improve survival in Hong Kong. Three delays were found in the traditional response by emergency medical service, namely in the collapse/recognise-to-call receipt, call receipt-to-vehicle stops, and vehicle stops-to-first defibrillatory shock time intervals. The first delay is related to public education, while the second and third delays are intrinsic to a dispatched response. A public access defibrillation programme employing responders at scenes of cardiac arrests can eliminate the collapse/ recognise-to-call receipt and call receipt-to-vehicle stops time intervals before defibrillation. Possible sites of public access defibrillation could include the airport and other immigration points, which have a high volume of people passing through, with projected figures for out-of-hospital cardiac arrest at these sites supporting this consideration. For successful implementation of public access defibrillation, a comprehensive educational programme and coordination with the emergency medical service are required.

This paper presents the first two successful cases of pre-implantation genetic diagnosis in Hong Kong and discusses the indications and the advantages over prenatal diagnosis. Patients should be informed about the procedure and extensively counselled about the possibility of misdiagnosis and the need for conventional prenatal diagnosis during pregnancy.

The prone table machine is a mammographic X-ray system specially designed for use in the stereotactic localisation of breast abnormality. In this study, its clinical usefulness was investigated in terms of duration, success rate, complications, and patients’ acceptance of the procedure. During a 5-month period, 79 patients attended the Kwong Wah Hospital for stereotactic-guided biopsy on the prone table. Eighty-one lesions were assessed—seven by fine needle aspirations, 67 by large-core needle biopsies, and seven by vacuum-assisted biopsies. Most of the biopsies were done because of clustered microcalcifications (77.8%) and the majority were of mammographically indeterminate nature (58.0%). The mean duration of the procedure was 49 minutes. A high degree of acceptance was experienced by patients. Only one patient had persistent haemorrhage after the biopsy. In conclusion, the prone table machine was considered to be useful and efficient, and had a high degree of acceptance among patients.

Emergency contraception is safe and effective for preventing an unplanned pregnancy, although it is not widely used. Widespread and appropriate use of emergency contraception should be encouraged as it is a promising means to arrest the increasing abortion rate. It is therefore important for all doctors to be able to prescribe emergency contraceptive pills and to educate women of reproductive age about emergency contraception. This article provides an update on the prescription of emergency contraceptives so that doctors may become more confident at prescribing emergency contraceptives and educating women about this back-up contraceptive. The current changes in the delivery of emergency contraceptive pills from prescriptiononly through self administration to over-the-counter sales will be discussed.

Acute pain services in public hospitals in Hong Kong were studied. Audit data on the volume and quality of acute pain services were collected prospectively from 1997 to 1999, and data on related facilities were collected in 2000. About 20% of patients undergoing a major operation received an acute pain service; of these, 78.6% were satisfied with the treatment provided. In 2000, 86% (18/21) of hospitals providing anaesthetic services were running an acute pain service. Staffing was better in hospitals providing a high volume of acute pain services, ranging from a full-time specialist anaesthesiologist assisted by a half-time trainee to a half-time specialist assisted by a full- or half-time trainee. However, only four hospitals were staffed with pain nurses. In total, 57% of patients received intravenous patient-controlled analgesia and 32% epidural analgesia. The mean duration of acute pain service treatment was 3.1 days. Currently anaesthesiologist-based acute pain services take care of a limited number of patients. To expand the coverage, there should be a move towards an anaesthesiologist-led, pain nurse–based, acute pain service. The present shortage of pain nurses should be addressed.