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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ResuscitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association.Circulation. 2020; 141: e139-e596
- Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.Resuscitation. 2017; 115: 129-134
- Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.Circulation. 2016; 134: 2095-2104
- Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos.N Engl J Med. 2000; 343: 1206-1209
- 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
- A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.N Engl J Med. 2018; 379: 711-721
- Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest.N Engl J Med. 2016; 375: 802-803
- 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
- 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
- Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.N Engl J Med. 2015; 372: 2316-2325
- Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest.J Am Coll Cardiol. 2020; 76: 43-53
- Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.Resuscitation. 2017; 114: 73-78
- A smartphone application for dispatch of lay responders to out-of-hospital cardiac arrests.Resuscitation. 2018; 126: 160-165
- 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
- A text message alert system for trained volunteers improves out-of-hospital cardiac arrest survival.Resuscitation. 2016; 105: 182-187
pulsepoint.org/stats. Available from: https://www.pulsepoint.org/stats.
- 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
- 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
- Can you get there from here? An analysis of walkability among PulsePoint CPR alert dispatches.Resuscitation. 2020; 148: 135-139
- Immediate psychological impact on citizen responders dispatched through a mobile application to out-of-hospital cardiac arrests.Resuscitation Plus. Elsevier, 2021
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.