Administration and Leadership, Cardiac & Resuscitation, Communications & Dispatch, Exclusives, Top Story

Electronic Community Alerting and Response to Cardiac Arrest

Public safety agencies are increasingly using mobile apps to engage CPR-trained citizens on nearby out-of-hospital cardiac arrest (OHCA) events occurring in their community. For extremely time sensitive emergencies like cardiac arrest, notifying these “first-first responders” who are in the immediate vicinity of an event—simultaneously with the conventional Fire/EMS response—offers the potential to improve outcomes.

By expanding situational awareness beyond the purview of a traditional witnessed arrest radius, there’s a better opportunity to instantly draw skilled individuals, including off-duty healthcare professionals, enabling critical life-sustaining BLS interventions to begin sooner and more often.

Over the past eight years, government and non-profit organizations have developed mobile app initiatives to bridge the gap between a cardiac arrest event and the arrival of a traditional prehospital response. These apps work effectively to match victims in cardiac arrest with nearby CPR-trained individuals. Some solutions only target vetted healthcare professionals, while others target both professionals and lay rescuers with only basic training.

Rescuer notifications are typically driven by the local jurisdiction’s computer-aided dispatch (CAD) system, the same system used to dispatch emergency responders. If the call-taker-driven emergency medical call protocol determines that a cardiac arrest event has likely occurred, emergency responders and nearby app responders are notified simultaneously.

There are also some solutions that activate responders via a separate app, eliminating the need for a technical interface to the dispatch system. 

Responders voluntarily participate in these programs by installing an app on their cellphone. When a responder receives an alert, they can choose to immediately initiate lifesaving treatment prior to the arrival of emergency responders. Currently, most bystanders who provide CPR either witness the event themselves or are directed to do so by a 9-1-1 dispatcher.

Often, friends and family are reluctant to provide CPR and trained citizens who may be nearby are unaware that help is needed. With implementation of this type of mobile technology, the likelihood that a sudden cardiac arrest victim will receive CPR from a trained citizen responder increases.

Many off-duty firefighters, EMS providers and medical professionals are willing and able to respond to nearby cardiac arrests. At any given time, approximately two-thirds of “24-hour” emergency personnel are off-duty. The value of being able to communicate immediately with these professional responders for off-duty response may considerably expand the reach and quality of early CPR in a community.

Along with the victim’s location, these apps also commonly provide the location of nearby AEDs. Early application of an AED is one of the crucial steps in the chain of survival for a patient who has experienced sudden cardiac arrest. Trained dispatchers will often ask if there’s an AED present when the patient’s condition warrants this lifesaving device; however, it’s entirely plausible that the person on the emergency call is unaware of the location of the closest AED.

There are many benefits to using technology to alert qualified individuals of a citizen/off-duty response in conjunction with community bystander CPR and AED programs. Ultimately, they can improve survival from OHCA in both rural and metropolitan communities and should be widely available and utilized.