PulsePoint dispatch associated patient characteristics and prehospital outcomes in a mid-sized metropolitan area

      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

      To read this article in full you will need to make a payment
      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Virani S.S.
        • et al.
        Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association.
        Circulation. 2020; 141: e139-e596
        • Geri G.
        • et al.
        Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.
        Resuscitation. 2017; 115: 129-134
        • Rajan S.
        • et al.
        Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.
        Circulation. 2016; 134: 2095-2104
        • Valenzuela T.D.
        • et al.
        Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos.
        N Engl J Med. 2000; 343: 1206-1209
        • Nakashima T.
        • et al.
        Public-access defibrillation and neurological outcomes in patients with out-of-hospital cardiac arrest in Japan: a population-based cohort study.
        Lancet. 2019; 394: 2255-2262
        • Perkins G.D.
        • et al.
        A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.
        N Engl J Med. 2018; 379: 711-721
        • Kudenchuk P.J.
        • et al.
        Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest.
        N Engl J Med. 2016; 375: 802-803
        • Wang H.E.
        • et al.
        Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial.
        JAMA. 2018; 320: 769-778
        • Benger J.R.
        • et al.
        Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial.
        JAMA. 2018; 320: 779-791
        • Ringh M.
        • et al.
        Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.
        N Engl J Med. 2015; 372: 2316-2325
        • Andelius L.
        • et al.
        Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest.
        J Am Coll Cardiol. 2020; 76: 43-53
        • Caputo M.L.
        • et al.
        Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.
        Resuscitation. 2017; 114: 73-78
        • Berglund E.
        • et al.
        A smartphone application for dispatch of lay responders to out-of-hospital cardiac arrests.
        Resuscitation. 2018; 126: 160-165
        • Zijlstra J.A.
        • et al.
        Local lay rescuers with AEDs, alerted by text messages, contribute to early defibrillation in a Dutch out-of-hospital cardiac arrest dispatch system.
        Resuscitation. 2014; 85: 1444-1449
        • Pijls R.W.
        • et al.
        A text message alert system for trained volunteers improves out-of-hospital cardiac arrest survival.
        Resuscitation. 2016; 105: 182-187
      1. pulsepoint.org/stats. Available from: https://www.pulsepoint.org/stats.

        • Dainty K.N.
        • Vaid H.
        • Brooks S.C.
        North American Public Opinion Survey on the Acceptability of Crowdsourcing Basic Life Support for Out-of-Hospital Cardiac Arrest With the PulsePoint Mobile Phone App.
        JMIR Mhealth Uhealth. 2017; 5e63
        • Brooks S.C.
        • et al.
        The PulsePoint Respond mobile device application to crowdsource basic life support for patients with out-of-hospital cardiac arrest: Challenges for optimal implementation.
        Resuscitation. 2016; 98: 20-26
        • Smida T.
        • et al.
        Can you get there from here? An analysis of walkability among PulsePoint CPR alert dispatches.
        Resuscitation. 2020; 148: 135-139
        • Kragh A.R.
        • et al.
        Immediate psychological impact on citizen responders dispatched through a mobile application to out-of-hospital cardiac arrests.
        Resuscitation Plus. Elsevier, 2021