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June 14, 2015 | by

Crowdsourcing CPR gets more help to cardiac arrest victims

If you go into cardiac arrest, getting help within the first few minutes can mean the difference between life and death. A new study shows that help can get to victims more quickly with a mobile-phone app that directs people who know CPR to medical emergencies near them.

The researchers call their app a “mobile-phone positioning system,” an homage to the network of satellites that make up the global positioning system, or GPS. The app uses the GPS function in mobile phones to find and contact bystanders trained in cardiopulmonary resuscitation who happen to be in the vicinity of a reported cardiac emergency. CPR-trained volunteers download the app if they are willing to get the alerts.

Dr. Leif Svensson, a cardiologist at the Center for Resuscitation Science at Karolinska Institutet in Stockholm, conceived of the research project 10 years ago during his morning commute. A 50-year-old woman’s heart stopped right outside the bus he was on.

“Nobody on the bus, including myself, saw this,” he said.

But when he arrived at the hospital for work, he saw the woman again, dead upon arrival in the emergency room.

“I was sitting approximately 10 to 15 feet from the place where she had her cardiac arrest,” Svensson recalled. If he had known of her condition earlier, he would have been able to help by performing CPR.

So Svensson recruited some colleagues and devised a system to “find your closest lifesaver,” as he put it. Whenever someone reported a case of cardiac arrest to emergency responders, all CPR-trained volunteers who were within about a third of a mile of the patient would receive a text message and a phone call to alert them to the emergency and the patient’s location.

To test how well it worked, Svensson and his team enlisted nearly 10,000 CPR-trained volunteers to participate in the study. The team activated the network and put out a call to volunteers after 306 cardiac arrests over a 20-month period. In those cases, a volunteer was able to initiate CPR 62% of the time.

View the full story by Sasha Harris-Lovett at the Los Angeles Times.

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Steve Lopez, LA Times

August 10, 2014 | by

App could boost chances of cardiac arrest victims

Later this month I’ll be marking the two-year anniversary of my death.

That’s not a line you see too often, is it?

My heart gave out after knee surgery, because of an arrhythmia. Even for those who suffer cardiac arrest in a hospital, the survival rate is low. But I was lucky. A nurse quickly used CPR and brought me back from the dead in less than a minute.

CPR-needed Alert MapLast week while driving to work I heard my cardiologist, Dr. Leslie Saxon, on KNX-AM (1070) talking about a new app that could save the lives of those stricken by cardiac arrest. The Los Angeles County Fire Department is encouraging civilians to download the app and join a growing army of crowd-sourced good Samaritans — 13,000 so far — who can keep someone alive until emergency crews arrive.

Before I tell you how the app works and how simple it is to use, let me tell you why it’s so important.

Cardiac arrest is a leading cause of death, killing more than 1,000 people a day in the United States. The victims, who include children, often have no symptoms and consider themselves perfectly healthy. As opposed to a heart attack (a plumbing problem in which blood flow to the heart is blocked), cardiac arrest is the sudden loss of heart function caused by an electrical malfunction in which the heart’s pumping action is disrupted.

Without CPR — and I mean chest compressions, not mouth-to-mouth resuscitation — death can occur within minutes. That means a five-minute response to a 911 call might be too late.

“It’s going to take a community to impact the dismal survival rates for out-of-hospital cardiac arrest patients,” Saxon said.

The idea for the app was hatched several years ago by a Bay Area fire chief who thought there must be a way to put the 13 million people with CPR training to better use. So, what if the moment someone dialed 911 in a case of cardiac arrest, nearby civilians could be notified on their mobile phones and do CPR until paramedics arrive?

Richard Price, now retired from the San Ramon Valley Fire Department, helped establish a nonprofit that has now linked its PulsePoint app to emergency systems in about 200 California fire departments and several hundred more around the country. He said the Los Angeles Fire Department may be signing on soon.

“There have been some pretty significant stories of lives saved, directly attributable to the app,” Price said.

Most interventions, so far, have been by off-duty emergency responders who downloaded the app. But as Price points out, any civilian can learn CPR in a matter of minutes. The PulsePoint app itself has a “how-to” feature with a diagram on how to place the heels of the hands in the center of the chest and push down firmly and rapidly, about 100 times per minute.

If you have the app and you’re in the L.A. County Fire Department coverage area, you’ll get a beep on your iPhone or Android device if you’re within one-quarter mile of where the fallen person is. Although it might be best in some cases to simply do CPR until trained responders arrive, a related app will give you a map showing where the nearest portable Automated External Defibrillator, or AED, is located.

Even if you’re not comfortable using one, you might be able to alert someone who is. Not all cases of cardiac arrest call for an AED, but the machines are designed for quick diagnosis, with clear and simple instructions on safe use by lay persons.

Price said it will take some time for the location of all AEDs to be loaded into the app. And it’s going to take some time, as well, for AEDs to become more prevalent. Concerns about cost ($1,200 or more per unit) and legal liability have impeded wider use.

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Bob Roy, a Riverside man whose 14-year-old son, Travis, went into cardiac arrest at his middle school in 2005 and later died, has been lobbying to require schools to have AEDs.

“You’re a hundred times more likely to need an AED than a fire extinguisher, and which of those two are required by law?” asked Roy, who has helped place dozens of the devices in schools through the nonprofit thetravisfund.org.

Former state Sen. Joe Simitian, now a Santa Clara County supervisor, said resistance to AEDs is based in part on fears of legal liability if the devices malfunction. But the technology has improved dramatically since regulations were written, he said, and it may be time to legislatively broaden legal protection for those willing to try to save someone’s life.

More people die each year from cardiac arrest than from lung, breast, prostate and colon cancer combined. And Dr. Frank Pratt, medical director for the L.A. County Fire Department, says it’s time for cardiac arrest to be addressed with the same urgency.

“If this number of people were dying from an infection or a defect in an automobile or a stove, there’d be a national uproar,” Pratt said. “The PulsePoint app gives us an opportunity to reinvigorate the dialogue on the whole public health problem of sudden cardiac arrest.”

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August 6, 2014 | by

LA County Fire Dept. cardiac arrest app to ‘crowd-source good Samaritans’

Hoping to turn regular cellphone-toting Angelenos into rapid responders, the Los Angeles County Fire Department has linked its dispatch system to a cellphone app that will notify CPR-trained good Samaritans when someone in a public place nearby is having a cardiac arrest.

The app, called PulsePoint, sends Fire Department alerts out to mobile phone users at the same time that dispatchers send the official message out to emergency crews — increasing the possibility that a cardiac arrest victim can get life-saving CPR from a bystander while medical responders are still on the way, department officials said Wednesday.

The program also provides cardiopulmonary resuscitation instructions and the location of defibrillators nearby.

“Every person who knows CPR, downloads this app and activates it has their own fire department radio in their pocket,” said Fire Department medical director Dr. Franklin Pratt. “They become the first first responder.”

Enlisting nearby citizens who are prepared to deliver “hands-only CPR” — hard and fast compressions in the center of the chest — could greatly improve survival rates among cardiac arrest sufferers, Los Angeles County fire officials said.

Fire Chief Daryl L. Osby, who was on hand for a press event in Inglewood debuting the system, told The Times that the average emergency crew response time for his department was 5 minutes countywide, and sometimes longer in lower-density, far-flung communities such as Lancaster and Palmdale.

“If a citizen can begin CPR before the paramedics arrive, it increases survival,” he said.

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Medical director Pratt said that when the heart stops beating, the opportunity for survival with a good quality of life diminishes after about 3 or 4 minutes because of injury to the brain and changes in the body that make the heart less responsive. But in the first couple of minutes after cardiac arrest there’s still oxygen in the blood, he added. Immediate CPR can keep that oxygen flowing to the brain.

View the full story by Eryn Brown at the Los Angeles Times.

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