Cardiac concussion is a sudden, direct blunt trauma cause to the chest which led to death. However, there are patients who did not completely fulfil this definition. We report two cases which did not fit into the definition domain. Two male patients presented to Emergency Department with moderate anterior chest pain after motor vehicle crash showed transient anterior ST segment elevation at chest lead V2 and V3 with raised creatine kinase and normal troponin T. The electrocardiogram changes fully resolved after 24 hours. Both patients were discharged uneventfully after 24 hours monitoring in Emergency Department short-stay ward. Conventional definition of cardiac concussion (commotion cordis) and cardiac contusion may be unsuitable to describe these cases. Therefore, we propose the diagnosis of focal cardiac concussion. We also highlighted the ability of Emergency Department to manage these patients in short-stay ward.
Commotio Cordis

Bystander rate of cardiopulmonary resuscitation (CPR) is still low worldwide because of inadequate skills and knowledge. Training the public on CPR is one of the methods to increase the bystander CPR rate. This study aimed to compare the efficacy in acquiring and retaining CPR skills and knowledge among secondary school students in Klang Valley trained by school teachers and medical students. We recruited five school teachers and five medical students as trainers. They were trained in several sessions by American Heart Association (AHA)-certified instructors using the video-assisted CPR training module. The recipients were 44 secondary school students divided between the teacher’s group and the medical student’s group. We compared knowledge and psychomotor skills between these two groups prior, immediately after and at three months after CPR training. Students in the teacher’s group showed a higher increase in knowledge comparable to the medical student’s group (median score difference 3 vs 2, p>0.05) and in psychomotor skill (median score difference 5 vs. 7, p<0.05). The level of knowledge and skills decreased after 3 months but remained significantly higher than at baseline for both groups. In conclusion, teachers could provide CPR training to their students as effective and retainable as medical students. This study aims to create an opportunity to teach CPR to the public in a larger scale.