Abstract
Background
Mobile phone-based dispatch of volunteers to out-of-hospital cardiac arrests (OHCA)
has been shown to increase the likelihood of early CPR and AED application. In the
United States, limited characterization of patients encountered as a result of such
systems exists.
Aims
Examine prehospital case characteristics and outcomes from a multi-year deployment
of PulsePoint Respond in Pittsburgh, Pennsylvania.
Methods
PulsePoint event timing, location, and associated prehospital electronic health records
(ePCRs) were obtained for EMS-encountered OHCA cases that did and did not generate
PulsePoint alerts within the service area of Pittsburgh EMS from July 2016 to October
2020. ePCRs were reviewed and OHCA case characteristics were extracted according to
the Utstein template. PulsePoint-associated OHCA and non-PulsePoint-associated OHCA
were compared.
Results
Of 840 total PulsePoint dispatches, 64 (7.6%) were for OHCA associated with a resuscitation
attempt. Forty-one (64.1%) were witnessed, 38 (59.4%) received bystander CPR, and
13 (20.0%) of these patients had an AED applied prior to EMS arrival. Twenty-seven
(39.7%) had an initial shockable rhythm, and 31 (48.4%) patients achieved ROSC in
the field. In the city of Pittsburgh, there were 1229 total OHCA during the study
period, with an estimated 29.6% occurring in public. When PulsePoint-associated and
publicly occurring non-PulsePoint-associated OHCA were compared, baseline characteristics
(age, sex, witnessed status) were similar, but PulsePoint-associated OHCA received
more bystander CPR (p = 0.008).
Conclusions
A minority of PulsePoint dispatches in Pittsburgh were triggered by true OHCA. The
majority of OHCA during the study period occurred within private residences where
PulsePoint responders are not currently dispatched. PulsePoint dispatches were associated
with prognostically favorable OHCA characteristics and increased bystander CPR performance.
Keywords
- PulsePoint
- PulsePoint Respond
- CPR
- Bystander CPR
- Bystander defibrillation
- AED
- Automated external defibrillator
- Public access AED
- Out-of-hospital cardiac arrest
- Cardiac arrest
- OHCA
- Bystander CPR recruitment
- Bystander
- Crowdsourcing
- Crowdsourcing CPR
- BLS
- Bystander intervention
- Smartphone
- Smartphone app
- Smartphone application
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Article info
Publication history
Published online: November 11, 2021
Accepted:
November 5,
2021
Received in revised form:
November 2,
2021
Received:
June 25,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
