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- Past, Present and Future -



The importance of cardiopulmonary resuscitation (CPR) is becoming increasingly acknowledged among the medical profession. In 1966, a National Academy of Science - National Research Council (NAS-NRC) conference on CPR recommended the training of medical, allied health care, and other professionals in external chest compression techniques according to the standards of the American Heart Association (AHA)l. The American Heart Association established itself as the sole body responsible for the task of standardizing, updating and educating Basic and Advanced Cardiac Life Support (ACLS) for all medical professionals. By 1973, CPR training programs have been extended to the general public in the U.S.A.


The Past

Prior to 1983, Courses in Basic and Advanced Cardiac Life Support were conducted in sporadic and limited manner in some hospitals in Saudi Arabia.

In the summer of 1983 the College of Medicine, King Saud University took the initiative in contacting the American Heart Association to establish


* M. D., F. F. A. R. C. S. I., Associate Professor, Medical Director, Anaesthesia and I. C. U., College of Medicine and University Hospitals, King Saud University.

Address correspondence to: Dr. Mohammed A. Seraj, Associate Professor and Medical Director of Anaesthesia, College of Medicine and University Hospital, King Saud University, P.O.Box 2925, Riyadh 11461, Saudi Arabia.

489 M.E.J. ANESTH. 10(5), 1990


similar programs for various CPR activities in Saudi Arabia. Less than a year later, in March 1984, the first accredited Instructor Course was conducted in Riyadh.

Twenty four physicians of different specialities from the Kingdom of Saudi Arabia were enrolled and 18 became instructors. Two of the successful instructors who are faculty members of the College of Medicine were elected as Associate Faculty to the AHA. At the same time, the AHA recognized the College of Medicine, and King Khalid University Hospital (KKUH) as the main national center for CPR in the Kingdom of Saudi Arabia. Later in 1984, the College of Medicine established the Saudi Heart Association (SHA) aiming at delivering basic and advanced life support by a highly trained personnel on an integrated, stratified nationwide basis. Since that time implementation of nationwide courses in CPR were organized by the SHA. In 1986 a second team from the AHA was invited to conduct a second Instructor Course in conjunction with the SHA members, and this combined effort served to consolidate the gains already made.

The total number of courses organized and conducted by the national center were 44, 20 of which were for providers in Basic and Advanced Cardiac Life Support. Twenty courses were conducted for instructors in Basic Life Support (English and Arabic) and four courses were for instructors in Basic and Advanced Cardiac Life Support.

Subsequently, the standard Basic Cardiac Life Support course was translated into Arabic and several courses were conducted at the provider and instructor levels for emergency medical technicians (EMT), school teachers, various public departments and allied health science personnel. By 1988, the number of training centres has increased to 24 throughout the Kingdom of Saudi Arabia. Table 1 shows the recognized regional centers approved by the SHA over the past five years. Recently I have discovered accidentally that there are certain training centers (in Saudi Arabia) conducting CPR courses under recognized health institutions abroad other


Table I

Number of CPR Training Centers in the Kingdom of Saudi Arabia

1983 1984 1985 1986 1987 1988 Total

- 1 5 7 6 5 24






















than the American Heart Association, as for example in Jubail city with its industrial complexes. Such centers will come under the umbrella of the SHA in the near future.


Table 2

Centers Conducting Provider and Instructor Courses in Basic and Advanced Cardiac Life

Support in the Kingdom of Saudi Arabia

Name Year

1 . College of Medicine and King Khalid University Hospital

(National Center) 1984

2. King Abdul Aziz University Hospital, Riyadh 1985

3 . Armed Forces Hospital, Riyadh 1985

4 . King Khalid Eye Specialist Hospital, Riyadh 1986

5 . King Faisal Specialist Hospital, Riyadh 1986

6 . King Abdul Aziz Military Hospital (Tabuk) 1986

7 . King Fahd National Guard Hospital, Riyadh 1987



Table 3

Centers Conducting Courses in Basic Life Support in the Kingdom of Saudi Arabia

Name Year

1. Dammam Center - College of Medicine 1985

2. Central Hospital, Riyadh 1985

3. Red Crescent Society, (Training Centers) 1985

4. Kamees Mushayt 1986

5. National Guard Hospital (King Fahd Hospital) 1986

6. Paediatric and Maternity Hospital (Jeddah) 1986**

7. King Abdul Aziz University Hospital (Jeddah) 1986

8. Aramco (Dammam) 1987

9. College of Allied Sciences, Riyadh 1987

10. Hafr Al Baten Health Authority 1987

11. Prince Salman Hospital, Riyadh 1987

12. Security Forces Hospital, Riyadh 1987

13. Al Hafji Hospital 1988*

14. Abha Medical College 1988*

15. Al-Hada Armed Forces Hospital (Taif) 1988*

16. Health Institutes (M.O.H.) 1988*

17. Prince Salman Hospital (Riyadh) 1988*

** Function only during Hajj

* In the process of establishment


M.E.J. ANESTH. 10(5), 1990


The Present

The CPR training centers currently available in Saudi Arabia can be classified into two categories, those able to conduct the provider and instructor courses in Basic and Advanced Cardiac Life Support (Table 2), and those able to conduct the Basic Life Support only (Table 3).

The actual training program of the national center of the Saudi Heart Association started in the spring of 1984 where 50 medical profession certified as providers or instructors in Advanced Cardiac Life Support and 80 non-physicians were certified as provider in Basic Life Support. The number of certifications issued by all the centers in the Mngdom of Saudi Arabia were 6260, 9723 and 7379 in 1985, 1986 and 1987 respectively.

The number of personnel trained in CPR are somewhat higher than the aforementioned figures as there have been efforts to provide an educational training program in first aid where Heart Saver courses were introduced almost four years ago for traffic police, highway patrol, Red Crescent





Table 4

Number of personnel Certified in Basic andlor Advanced Cardiac Life Support by Different

Centers in 1987, in the Kingdom of Saudi Arabia

Name Number of


National Center 122

King Khalid University Hospital 856

King Abdul Aziz University Hospital 817

King Khalid Eye Specialist Hospital 431

King Fahd National Guard Hospital 624

Military Hospital 357

Central Hospital 244

Red Crescent Society 551

Dental School (KSU) 128

E.M.T. (KSU) 61

Medical School (KSU) 27

King Faisal Specialist Hospital and Research Center 734

Security Hospital 247

Hafr Al-Batin 172

Total 6379


personnel, school teachers, airport authorities and fire brigade (Civil Defence). The graduates of those programs are not included in the final figures in this article. Table 4 shows the number of personnel certified in Basic and Advanced Cardiac Life Support by different centers in the Kingdom of Saudi Arabia in 1987.


The Future

Collective cooperation must be assured in the very near future as new centers will be opened throughout the Kingdom of Saudi Arabia and more candidates will be certified and recertified. Application of non-teaching hospitals for postgraduate training status for the fellowships and the Arab Board requirements of training will help to enforce the standards of Basic and Advanced Cardiac Life Support throughout the medical profession. Community wide, there is an increased demand to educate the lay public in the principles of Basic Life Support as it has proved to be such an effective tool in maintaining brain tissue oxygenation and viability under emergency conditions, until emergency medical services (E.M.S.) arrive to the scene.

A short and long term plan have to be organized and conducted in a scheduled time to achieve such goals.



1. Cardiopulmonary resuscitation: Statement by the Ad Hoc Committee on Cardiopulmonary Resuscitation of the Division of Medical Sciences, National Academy of Science National Research Council. J.A.M.A. 198:372-379, 1966.








M.E.J. ANESTH. 10(5), 1990