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Mobile smartphone technology is associated with better clinical outcomes for OHCA

Mobile smartphone technology can accelerate first responder dispatch and may be instrumental to improving out of hospital cardiac arrest (OCHA) survival. That is the conclusion of a study published in the October 2020 issue of Academic Emergency Medicine (AEM), a journal of the Society for Academic Emergency Medicine (SAEM).The lead author of the study is Dr. Clement Derkenne, an emergency physician in the emergency medical department, Paris Fire Brigade, Clamart, France. The findings of the study are discussed in a recent AEM podcast, We Didn’t Start the Fire, But Can Antiacid Monotherapy Stop the Fire?

In France, the introduction of the mobile application “Staying Alive” (a free mobile smartphone application, available in 18 languages and compatible with all operating systems) improved healthcare delivery and OHCA survival outcomes within one year in the Greater Paris area (July 2017 to 2018).

Retrospective cohort cardiac arrest calls to Paris Fire Brigade with “Staying Alive” activation. Credit: KIRSTY CHALLEN, B.SC., MBCHB, MRES, PH.D., LANCASHIRE TEACHING HOSPITALS, UNITED KINGDOM

The application allows registered first responders, commonly referred to as “Bons Samaritains” (BS), located near an OHCA scene, to be alerted via a “push notification.” Upon acknowledgment of the notification, available BS are directed toward the scene of OHCA and receive a map of AEDs in the area.

SA is available on all smartphone platforms and uses geolocalization services to flag nearby AEDs. It was first integrated to the Paris Fire Brigade Greater Paris Area CPR protocols in 2017.


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The study researchers concluded that smartphone apps that match trained responders to nearby cardiac arrest victims may be a valuable way to improve response times in out of hospital cardiae arrest; however, their impact on clinical outcomes and overall cost effectiveness remains unclear.

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ABOUT ACADEMIC EMERGENCY MEDICINE Academic Emergency Medicine, the monthly journal of Society for Academic Emergency Medicine, features the best in peer-reviewed, cutting-edge original research relevant to the practice and investigation of emergency care. The above study is published open access and can be downloaded by following the DOI link: 10.1111/acem.13987. Journalists wishing to interview the authors may contact Stacey Roseen at [email protected].

ABOUT THE SOCIETY FOR ACADEMIC EMERGENCY MEDICINE SAEM is a 501(c)(3) not-for-profit organization dedicated to the improvement of care of the acutely ill and injured patient by leading the advancement of academic emergency medicine through education and research, advocacy, and professional development. To learn more, visit saem.org.


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Source:

Society for Academic Emergency Medicine

Journal Reference:

Mobile Smartphone Technology Is Associated With Out‐of‐hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience

Abstract
Background
Out‐of‐hospital cardiac arrest (OHCA) remains associated with very high mortality. Accelerating the initiation of efficient cardiopulmonary resuscitation (CPR) is widely perceived as key to improving outcomes. The main goal was to determine whether identification and activation of nearby first responders through a smartphone application named Staying Alive (SA) can improve survival following OHCA in a large urban area (Paris).

Methods


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We conducted a nonrandomized cohort study of all adults with OHCA managed by the Greater Paris Fire Brigade during 2018, irrespective of mobile application usage. We compared survival data in cases where SA did or did not lead to the activation of nearby first responders. During dispatch, calls for OHCA were managed with or without SA.

The intervention group included all cases where nearby first responders were successfully identified by SA and actively contributed to CPR. The control group included all other cases. We compared survival at hospital discharge between the intervention and control groups. We analyzed patient data, CPR metrics, and first responders’ characteristics.

Results
Approximately 4,107 OHCA cases were recorded in 2018. Among those, 320 patients were in the control group, whereas 46 patients, in the intervention group, received first responder–initiated CPR. After adjustment for confounders, survival at hospital discharge was significantly improved for patients in the intervention group (35% vs. 16%, adjusted odds ratio = 5.9, 95% confidence interval = 2.1 to 16.5, p < 0.001). All CPR metrics were improved in the intervention group.

Conclusions
We report that mobile smartphone technology was associated with OHCA survival through accelerated initiation of efficient CPR by first responders in a large urban area.

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