Characterization of non-cardiac arrest PulsePoint activations in public and private settings

Jennifer Blackwood; Mohamud R Daya; Ben Sorenson; Brian Schaeffer; Mike Dawson; Michael Charter; James Mark Nania; Julie Charbonneau; Jeremy Robertson; Michael Mancera; Chris Carbon; Dawn B Jorgenson; Mengqi Gao; Richard Price; Chris Rosse; Thomas Rea

doi:10.1186/s12873-023-00849-z

Characterization of non-cardiac arrest PulsePoint activations in public and private settings

BMC Emerg Med. 2023 Jul 27;23(1):79. doi: 10.1186/s12873-023-00849-z.

Authors

Jennifer Blackwood¹, Mohamud R Daya^{2

3}, Ben Sorenson³, Brian Schaeffer⁴, Mike Dawson⁴, Michael Charter⁵, James Mark Nania^{4

5

6}, Julie Charbonneau⁷, Jeremy Robertson⁷, Michael Mancera⁸, Chris Carbon⁹, Dawn B Jorgenson¹⁰, Mengqi Gao¹⁰, Richard Price¹¹, Chris Rosse¹², Thomas Rea^{13

12}

Affiliations

¹ Seattle & King County Public Health, 401 5th Ave, Suite 1200, Seattle, WA, 98104, USA. Jennifer.Blackwood@kingcounty.gov.
² Oregon Health & Sciences University, Portland, OR, USA.
³ Tualatin Valley Fire & Rescue, Tigard, OR, USA.
⁴ City of Spokane Fire Dept, Spokane, WA, USA.
⁵ Spokane Valley Fire, Spokane Valley, WA, USA.
⁶ Spokane County EMS Office, Spokane, WA, USA.
⁷ Sioux Falls Fire & Rescue, Sioux Falls, SD, USA.
⁸ University of Wisconsin-Madison, Madison, WI, USA.
⁹ City of Madison Fire Department, Madison, WI, USA.
¹⁰ Philips Medical, Bothell, WA, USA.
¹¹ PulsePoint Foundation, Pleasanton, CA, USA.
¹² University of Washington, Seattle, WA, USA.
¹³ Seattle & King County Public Health, 401 5th Ave, Suite 1200, Seattle, WA, 98104, USA.

Abstract

Background: Geospatial smartphone application alert systems are used in some communities to crowdsource community response for out-of-hospital cardiac arrest (OHCA). Although the clinical focus of this strategy is OHCA, dispatch identification of OHCA is imperfect so that activation may occur for the non-arrest patient. The frequency and clinical profile of such non-arrest patients has not been well-investigated.

Methods: We undertook a prospective 3-year cohort investigation of patients for whom a smartphone geospatial application was activated for suspected OHCA in four United States communities (total population ~1 million). The current investigation evaluates those patients with an activation for suspected OHCA who did not experience cardiac arrest. The volunteer response cohort included off-duty, volunteer public safety personnel (verified responders) notified regardless of location (public or private) and laypersons notified to public locations. The study linked the smartphone application information with the EMS records to report the frequency, condition type, and EMS treatment for these non-arrest patients.

Results: Of 1779 calls where volunteers were activated, 756 had suffered OHCA, resulting in 1023 non-arrest patients for study evaluation. The most common EMS assessments were syncope (15.9%, n=163), altered mental status (15.5%, n=159), seizure (14.3%, n=146), overdose (13.0%, n=133), and choking (10.5%, n=107). The assessment distribution was similar for private and public locations. Overall, the most common EMS interventions included placement of an intravenous line (43.1%, n=441), 12-Lead ECG(27.9%, n=285), naloxone treatment (9.8%, n=100), airway or ventilation assistance (8.7%, n=89), and oxygen administration (6.6%, n=68).

Conclusions: More than half of patients activated for suspected OHCA had conditions other than cardiac arrest. A subset of these conditions may benefit from earlier care that could be provided by both layperson and public safety volunteers if they were appropriately trained and equipped.

Keywords: Crowdsourcing; Emergency medical services; Out-of-hospital cardiac arrest; Prehospital; Social media.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiopulmonary Resuscitation* / methods
Emergency Medical Services*
Humans
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / therapy
Prospective Studies
Respiration, Artificial