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Crowdsourcing for CPR

CPRapp
A few weeks ago, I sat in a CPR class and watched several dramatizations, the ones that reenact a cardiac emergency. In the videos, a person collapses in the street, and a Good Samaritan immediately rushes to their side to perform the life-saving technique. Imagine if all the people who suffered a cardiac arrest were as fortunate, I thought. Their risk of death would be cut in half, maybe more.

In reality, I later found out, the chance of a bystander stepping in to perform CPR – cardiopulmonary resuscitation – on someone who goes into cardiac arrest outside of the hospital in the United States hovers around 40 percent. In Philadelphia, the numbers are far worse - around 14 percent, according to the latest data from the Cardiac Arrest Registry to Enhance Survival.

Well aware of these stats, nonprofits like the American Heart Association (AHA) and the emergency responders and physicians who treat these patients are working hard to help turn that around with more CPR outreach and training, resuscitation research to inform the constantly evolving guidelines, and better technological approaches. Yes, there’s an app for it.

“The biggest problem when someone collapses is that there is no one around to administer CPR and you have to wait for the ambulance,” said Benjamin Abella, MD, MPhil, clinical research director of the Penn Center for Resuscitation Science. “But what if in the restaurant right across the street there was paramedic, a cop or someone who knows CPR and wants to help.”

That’s the thinking behind PulsePoint, the increasingly popular app that has taken off in the West and quickly made its way toward the Atlantic and up its coast. The app alerts nearby CPR-trained people that someone went into cardiac arrest within a 1/8 of a mile. Users download the free app and agree to receive the alerts. “It’s crowdsourcing for cardiac arrest help,” Abella said.

It’s triggered by the 911 call, so cities need to coordinate with the nonprofit who developed it, PulsePoint Foundation, and pay a fee to sync it with their dispatch chatter. The app shows where the victim is, as well as where the nearest automated external defibrillator (AED) is located to jump start the person’s heart.

“It’s one of those growing trends that I think we’re going to start to see more and more of,” Abella said. “A lot of forward-thinking cities are giving it a go.”

Emergency responder departments in cities in Florida, Virginia and New York just launched the app this month. It’s not yet available in Philadelphia, but its close neighbor, Montgomery County, plans to launch the app within the next few months.

“The reason we decided to pursue this is that the survival rate for sudden cardiac arrest, just out on the street should you be so unfortunate, is only about eight percent,” Val Arkoosh, MD, the Montgomery County Commissioners’ Chairwoman told the newspaper The Reporter in December. “… [T]his will just be another tool in that toolbox to increase survival when someone collapses on the street or in their home,” she added.

Abella called the data from a 2015 New England Journal of Medicine study supporting the use of such apps “really impressive.”  

The researchers showed a significantly higher number of bystander-initiated CPR when people received alerts on their phone compared to those who didn’t get the alert (62 vs. 48 percent). That prompted the AHA to release new guidelines supporting the use of mobile devices to connect victims with CPR-trained people.

“Accessing people through a mobile network can get help to the scene faster,” Raina Merchant, MD, director of the Social Media and Health Innovation Lab at Penn Medicine, told the AHA when the new guidelines were issued after the study was published. “While emergency system personnel are on their way, bystanders can come by and start helping out.”

mobilevan
Though Philadelphia may not have the new app just yet, it’s running another innovative project to help save lives.

In partnership with the city of Philadelphia, the CPR Mobile Project aims to educate the city’s residents in hands-only CPR, free of charge, using a video learning approach that takes less than 30 minutes. The program was created to increase survival from sudden cardiac arrest by traveling to the people to teach them CPR, instead of the other way around.

For the last eight months, certified health care providers have been traveling around the city to community centers, shelters, schools, religious organizations, and community health fairs in the Mobile CPR van.

Since its launch last summer, they’ve trained over 800 people. Their goal is 10,000 in three years, said Abella, who serves as the director of the project.

“Every year, over 1,000 people die from cardiac arrest events in this city,” he said. “All of these approaches are working toward the same goal: to administer CPR to more cardiac arrest victims. Time is of the essence in these situations, and we know that intervening buys more of it and increases their chance of making it.”

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