Crowd Sourcing CPR

Welcome to the new year!

First up the I-Tunes link! This will work with RSS feeds and I-tunes for all the podcast goodness
https://itunes.apple.com/au/podcast/downstairs-care-outthere-podcast/id876296199

Kicking off the newyear with a Podcast between my self and David Still from the ACT @Davidstill
David is a 4th year Paramedics/ Nursing Student (he was in 3rd when we recorded) who recently submitted a conference poster on the use of smartphone activation of public response for apparent public cardiac arrest.

He also participated in the FERNOSIM as a member of one of ACU’s Teams and we have a little reflection on how they could have trained better.

The link to my I-Tunes feed for the podcast are right here, please, if you enjoy it subscribe leave a review and come and interact on the blog or twitter.
If you haven’t already share the podcast with your friends, get it going around. Try and use the new year to get someone into #FOAMED
For all of Australasian Journal Of Paramedics:

http://ajp.paramedics.org/index.php/ajp
Abstracts for SPA 2014
http://ajp.paramedics.org/index.php/ajp/article/view/132

Abstracts for PAIC 2014
http://ajp.paramedics.org/index.php/ajp/article/view/138
The papers David and I talked about relating to his poster, complete with links to find them, a few are behind paywalls.

American Heart Association. Improving Survival From Sudden Cardiac Arrest:
The “Chain of Survival” Concept. Circulation. 1991 May; 83(5): p. 1832-1847.
http://circ.ahajournals.org/content/83/5/1832.short

Brooks S. Abstract 191: Community Uptake of a Smartphone Application to
Recruit Bystander Basic Life Support for Victims of Out-of-Hospital Cardiac
Arrest. Circulation. 2012;(126): p. A191.

Brooks S, Worthington H, Gonedalles T, Bobrow B, Morrison L. Implementation
of the PulsePoint smartphone application for crowd-sourcing bystander
resuscitation. Critical Care. 2014; 18(Suppl 1): p. S176.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069540/
Scholten A, van Manen J, van der Worp W, Ijzerman M, Doggen C. Early
cardiopulmonary resuscitation and use of Automated External Defibrillators by
laypersons in out-of-hospital cardiac arrest using an SMS alert service.
Resuscitation. 2011;(82): p. 1273-1278.

http://www.ncbi.nlm.nih.gov/pubmed/21652136
Yonekawa C, Suzukawa M, Yamashita K, Kubota K, Yasuda Y, Kobayashi A, et
al. Development of a first-responder dispatch system using a smartphone.
Journal of Telemedicine and Telecare. 2014; 20(2): p. 75-81.

http://www.ncbi.nlm.nih.gov/pubmed/?term=evelopment+of+a+first-responder+dispatch+system+using+a+smartphone.
Ringh M, Fredman D, Nordberg P, Stark T, Hollenberg. Mobile phone technology
identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac
arrest victims prior to ambulance arrival. Resuscitation. 2011; 82(12).

http://www.ncbi.nlm.nih.gov/pubmed/21854731
Grasu A. SMS alerts for volunteer rescuers in the emergency system: Decreasing
the delay in starting cardiopulmonary resuscitation [abstract]. Resuscitation.
2013; 81 (Suppl 1).

http://www.resuscitationjournal.com/article/S0300-9572%2813%2900491-7/abstract

Zijlstra J, Stieglis R, Riedijk F, Smeekes M, van der Worp W, Koster R. 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.

http://www.ncbi.nlm.nih.gov/pubmed/25132473

American Heart Association. Primary Outcomes for Resuscitation Science Studies:
A Consensus Statement From the American Heart Association. Circulation.
2011 (124): p. 2158-2177.

http://www.ncbi.nlm.nih.gov/pubmed/21969010
Merchant, R., Asch, D., Hershey, J., Griffis, H., Hill, S., et al. A Crowdsourcing
Innovation Challenge to Locate and Map Automated External Defibrillators.
Circulation: Cardiovascular Quality and Outcomes. 2013 March, 6(2): p. 229-
236. DOI: 10.1161/CIRCOUTCOMES.113.000140

http://circoutcomes.ahajournals.org/content/6/2/229.extract
11. Sakai T, Iwami T, Kitamura T, Nishiyama C, Kawamura T, Kajino K, et al.
Effectiveness of the new ‘Mobile AED Map’ to find and retrieve an AED: A
randomised controlled trial. Resuscitation. 2011; 82(1): p. 69-73
http://www.ncbi.nlm.nih.gov/pubmed/21051130
If you would like to read further into what is being done with mobile phones;
http://www.resuscitationjournal.com/article/S0300-9572(11)00124-9/abstract?cc=y

http://www.resuscitationjournal.com/article/S0300-9572(07)00594-1/abstract

Featured photo is me and a classmate practicing CPR as first years at CSU 2009.
Facilities were basic, but the staff were motivated and challenging.

Bystander CPR and Heart Week 2014, and a story

Firstly, unaware it was Heart Week 2014 until I woke up from night-shift, Started the week with a Cardiac Arrest patient in which the team achieved Return of spontaneous circulation.

4-10th of May is Heart Week 2014, aiming to raise awareness of the symptoms of AMI and educate the public. The Heart Foundation has done a lot of education as to the warning signs and utility of early CPR, Early AED use, to the point where the average Australian has a passable command of CPR and AED use, even without formal training, awareness of  the importance of bystander CPR is growing, with good quality bystander CPR becoming commonplace due to the prevalence of  first aid certificates and CPR public awareness campaigns.

I was saving this story for later, however, Heart Week is as good a time as any, it concerns, Bystander CPR, Mental preparedness and a story that makes me immeasurably proud of my Father.

My father is a teacher, has spend the last 30+ year of his life teaching high school science, his medical training consists of the annual CPR refresher run online by his workplace, a 30 minute click through, multiple choice training package.

Every morning dad wakes up at six o’clock to walk the family dog, before heading off to work. This particular morning I was sipping my coffee when I heard the dog, out the front of the family house still on his the leash barking to get attention, dad usually brought him back around the back of the house, as soon as I was out the front, the dog took off back up the road, I chased after him as two ambulances had pulled around the corner, onto our street. There was a small crowd gathered outside one of the houses up the road.
The worst comes to mind, dog on the lead, ambulances, a crowd. Knowing ambulances duel respond to Cardiac arrest and not much else. I wait with the crowd, outside the house, increasingly concerned as to the location of my father.
When a neighbor walks up and asks if I’m Peters son. She’s the wife of the man that the Paramedics are currently working on. She tells me, my father was inside the house, he’d been walking the dog and she’d run out to the road looking for someone who knew CPR after her husband had collapsed, my father who was close by, offered his assistance. Having never done CPR outside of a classroom mannequin 3 years prior, my father put his hand up.
Asking another bystander to take the dog back to the house.

By the time the ambulance arrived the woman’s husband had been in cardiac arrest for 15 minutes. The entire time my father had been providing CPR, without a break to a person he didn’t know(Now I know this breaks every rule we have as professional rescuers, however no one on scene until the Ambulance was willing to take over CPR).
Once relieved by the Paramedics on scene my dad came out of the house.
We walked back to the house, made coffee and sat down.

This is by far the most enlightening conversation I’ve ever had with my dad. He talked about his experience in the house, about what he’d done, what he could have done differently and what was the chance of a good outcome for the man.
This was the first time my father had ever turned to me for advise and council. This was the first time I was ever able to talk to him as the expert on what he was doing.
After having this conversation with my dad, every time I come across a bystander providing CPR I make sure immediately as the come off the chest they are reassured, that they have done, well and done everything they could.

What does this have to do with mindset, this is the final point I want to address is often I’ve been to people that had a first aid certificate but failed to act, they had the technical knowledge but had failed to consider at that point the possibility they may have to use those skills at some point. If you ever teach CPR, to anyone, make sure they know, this is a skill that they need to know and when it comes time to use it they will have no time to weigh up the pros and cons of what they need to do.

I’m immensely proud of my father, because despite his lack of training, because of the person he is, he was able to act in a purposeful way and come to the aid of a person in need.
(He has since attended a proper first aid course, and a Advanced medical training I ran through my old job as an attendant and speaker)

I felt this was an appropriate week to share the story, permission was sought to share this story.

My father an I during the first day of the Overland Track Tasmania