Cities nationwide should consider using mobile phones and apps to connect people in cardiac arrest with nearby CPR-trained rescuers, say new guidelines from the American Heart Association.
The guidelines, published Thursday in Circulation, claim that such community programs could increase bystander CPR, which, depending on the community, is performed in 10 percent to 65 percent of the roughly 326,000 cardiac arrests that happen outside the hospital each year.
Accessing people through a mobile network can get help to the scene faster, said Raina Merchant, M.D., director of the Social Media and Health Innovation Lab at Penn Medicine.
“While emergency system personnel are on their way, bystanders can come by and start helping out,” said Merchant, an assistant professor of emergency medicine at the University of Pennsylvania Perelman School of Medicine who was not involved in writing the new guidelines.
About 90 percent of American adults have cellphones and two out of three have smartphones, according to the Pew Research Center.
The new recommendation is largely based on a Swedish study that tested a mobile alert system in Stockholm. The study, published in June in The New England Journal of Medicine, found that bystander CPR was initiated in 62 percent of cardiac arrests among the group who received cellphone alerts. In the group that did not receive alerts, CPR was performed 48 percent of the time.
“There’s a lot of work that needs to be done about how to best optimize these programs,” said Merchant. “Simply having the program doesn’t ensure that people will use it.”
About 1,400 U.S. communities are implementing a CPR mobile alert program developed by the nonprofit PulsePoint Foundation, said president Richard Price. When a cardiac arrest happens, 911 dispatch centers alert responders within a quarter mile of the patient.
Potential responders register through a free mobile app, which alerts them when an emergency occurs, maps directions and reminds them how to give chest compressions. After the emergency, the system sends the local EMS agency a detailed report about the incident and surveys responders about their actions.
“By directly alerting those who are qualified and nearby, maybe in the business next door or on the floor above, PulsePoint is able to put the right people in the right place at the right time,” Price said.
Annual costs to implement the system range from $8,000 a year for communities with up to 300,000 residents to $28,000 a year for populations of 1.5 million or more, according to Price.
Communities already using the alert programs will aid in research about why people respond and how to get them to respond, said Merchant.
In addition to summoning rescuers, cellphones also allow people at the scene of a cardiac emergency to get CPR instructions from 911 dispatchers without leaving the victim’s side.
Dispatchers should be trained to help callers recognize cardiac arrest quickly and walk them through chest compressions, the guidelines say.
The AHA recommends that anyone who sees a teenager or adult suddenly collapse call 911 and push hard and fast on the center of the chest, a technique known as Hands-Only CPR.
The AHA guidelines have been updated every five years through a complex process involving more than 250 international experts from the AHA and six other resuscitation councils that form the International Liaison Committee on Resuscitation.
At an AHA-hosted ILCOR conference in early 2015, seven expert panels discussed, debated and reached consensus on hundreds of resuscitation topics, based on research published since the 2010 guidelines.
The AHA used that scientific consensus to create the CPR and Emergency Cardiovascular Care guidelines: “how-to” manuals that translate the science into practice. They are used to train millions of potential rescuers and are integrated into state and local emergency medical services protocols.
“CPR saves lives. That’s the big take-home from the guidelines. A lot of the science that works continues to work,” said Merchant.
“We need more people to do CPR,” she said. “Some will be through mobile, some will be through dispatchers … some will be remembering from a training class. [Mobile] is one part of the solution, but not the only piece.”