Evaluating the PulsePoint Mobile Device Application to Increase Bystander Resuscitation for Victims of Sudden Cardiac Arrest

简要总结

详细描述

Out-of-hospital cardiac arrest (OHCA) is a major public health problem. More than 45,000 Canadians suffer OHCA annually, with only 8.4% surviving to hospital discharge. Early bystander cardiopulmonary resuscitation (CPR) and defibrillator use can save lives but are rarely done. Advances in mobile device technology have allowed the development of a system which can notify CPR-trained citizens within 400 meters of a possible cardiac arrest. The PulsePoint mobile device application (www.pulsepoint.org) empowers them to respond and provide basic life support while professional crews are being dispatched. When a mobile device receives the alert data from the PulsePoint system, the application presents a map showing the exact location of the emergency and the closest public access defibrillator. PulsePoint will be implemented in 2 regions across Canada and the US (British Columbia and Columbus, Ohio). After a coordinated marketing campaign in each participating region to maximize the number of mobile device application downloads in the community, 9-1-1 calls for suspected cardiac arrest will be randomized to conventional dispatch for suspected cardiac arrest versus conventional dispatch plus PulsePoint notifications. The primary outcome will be bystander CPR or defibrillator use prior to professional responders arriving on scene. The primary analysis will involve comparing outcomes between the control and treatment groups among randomized patients who satisfy inclusion and exclusion criteria and have at least one PulsePoint responder within 400 meters of the cardiac arrest event. The investigators hypothesize that the PulsePoint system will have an immediate impact on increasing bystander CPR and defibrillator use in participating communities. In the long term, this project will provide valuable data on how effective PulsePoint is with respect to bystander resuscitation and survival. The data will directly inform policy decisions about PulsePoint implementation in the participating communities and guide other North American jurisdictions around these policy decisions in the future.

主要结局

次要结局

• Proportion of patients receiving bystander CPR (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)
• Proportion of patients receiving bystander defibrillator use (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)
• Proportion of patients receiving bystander defibrillator shock delivered (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)
• Proportion of patients with return of spontaneous circulation (secondary effectiveness outcome)(Patients are followed from EMS arrival on scene until arrival at hospital, an expected average of 35 minutes.)
• Proportion of patients surviving to hospital discharge (secondary effectiveness outcome)(Patients are followed until death or discharge from hospital, an expected average of 30 days.)
• Proportion of patients surviving to hospital discharge with good functional outcome (secondary effectiveness outcome)(Patients are followed until death or discharge from hospital, an expected average of 30 days.)
• EMS response time interval (secondary safety outcome)(Expected average of 5 minutes.)
• EMS on scene time interval (secondary safety outcome)(Expected average of 30 minutes.)
• Proportion of patients receiving bystander interference with the resuscitation effort (secondary safety outcome)(Patients will be followed for this outcome in the time interval between 9-1-1 call and EMS departure from scene, an expected average of 35 minutes.)
• Number of PulsePoint application downloads (secondary system performance outcomes)(Downloads in the participating communities will be tracked for the duration of the anticipated 2 year patient recruitment time frame.)
• Number of PulsePoint application users notified (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• Sensitivity of PulsePoint activation (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• False positive rate for PulsePoint activation (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• Proportion of patients receiving bystander defibrillator shock delivered (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)
• Proportion of patients with return of spontaneous circulation (secondary effectiveness outcome)(Patients are followed from EMS arrival on scene until arrival at hospital, an expected average of 35 minutes.)
• Proportion of patients surviving to hospital discharge (secondary effectiveness outcome)(Patients are followed until death or discharge from hospital, an expected average of 30 days.)
• Proportion of patients surviving to hospital discharge with good functional outcome (secondary effectiveness outcome)(Patients are followed until death or discharge from hospital, an expected average of 30 days.)
• EMS response time interval (secondary safety outcome)(Expected average of 5 minutes.)
• EMS on scene time interval (secondary safety outcome)(Expected average of 30 minutes.)
• Proportion of patients receiving bystander interference with the resuscitation effort (secondary safety outcome)(Patients will be followed for this outcome in the time interval between 9-1-1 call and EMS departure from scene, an expected average of 35 minutes.)
• Number of PulsePoint application downloads (secondary system performance outcomes)(Downloads in the participating communities will be tracked for the duration of the anticipated 2 year patient recruitment time frame.)
• Number of PulsePoint application users notified (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• Sensitivity of PulsePoint activation (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• False positive rate for PulsePoint activation (secondary system performance outcome)(This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.)
• Proportion of patients receiving bystander CPR (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)
• Proportion of patients receiving bystander defibrillator use (secondary effectiveness outcome)(Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.)