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New App Connects CPR Volunteers, Heart Attack Victims, Emergency Dispatch and the iPhone

Fire Department App – PSA from Fire Department on Vimeo.

Imagine, you’re in the middle of a weekly team meeting when your iPhone vibrates. You stand up and calmly tell your coworkers, “There’s been a heart attack in the first floor gym. I’m CPR trained. I’ll be back as soon as I can.”

Similar scenarios may soon by playing out all over the country thanks to groundbreaking use of the location-aware features of modern smartphones and access to emergency dispatch information from local fire departments. In the San Francisco East Bay, it could be happening in a matter of days, as the San Ramon Valley Fire Protection District rolls out its new ‘Fire Department’ app for iPhone, which launches publicly today. (Added – Live Qik video of the launch press conference.)

I felt the world change
A couple weeks back, I found myself in Chief Richard Price’s office with my friend Joe Hackman, eyes glistening with tears as we watched a PSA video for the application (read Joe’s thoughts on what the new app means to our SF East Bay community). In the video, a 72-year-old man collapses at the lumber store; across the parking lot, a young man in an electronics store gets an alert “CPR needed” – his phone gives him an address and map of where to go, and shares the location of the nearest automated external defibrillator. Sitting in that office, seeing an app that puts real life-saving information at the fingertips of any willing and trained volunteer, I felt the world change.

The creators of this application have moved beyond the real‐time Web to the right time Web. – Tim O’Reilly, O’Reilly Media

Chief Price and his staff first conceived of this application more than a year ago, after an incident in which they were having lunch and learned on their radios that a man was having a heart attack just steps away. Heart attack-induced brain death begins in just minutes, and fire department staff simply cannot arrive fast enough to save most people – but any army of CPR-trained volunteers can. And while they have had to be in exactly the right place to respond, the new app will dramatically extend the ability of everyday citizens to save lives.

Price told me that he has just 43 firefighters on duty during the day, but in his suburban district of 170,000 people, 10 percent have CPR training. “You can see the significance,” he said. Area residents will see the app PSA in local movie theaters beginning this weekend.

Price and his staff developed the iPhone application in partnership with the Center for Applied Informatics at Northern Kentucky University. Over the coming weeks and months, he will work with the International Association of Fire Chiefs and developers at Workday to bring the free application to Android and other mobile platforms, and to spur widescale adoption.
Map on iPhone Showing Victim's Location and Nearest AED

“The value of this application is far too important to society to not ambitiously share it with other communities around the globe,” Price said.

In the San Ramon Valley alone, community members who download the new app could help respond to as many as 100 calls a year. Across the U.S., nearly 300,000 people die each year of cardiac arrest.

“I think in the big picture, what we recognize is that of the people who have sudden cardiac arrest, less than one in three get CPR,” said heart surgeon Junaid Khan, president of the American Heart Association’s East Bay board. “Without CPR, a person really has very little chance of survival. For the first time, a smart phone application can actually help save a life.”

‘You can get there faster’
Dr. Khan and Chief Price also talked about the added benefit of creating more responders. Historically, even CPR-trained individuals sometimes balk in the face of crisis, but now self-identified volunteers within 500 yards of a heart attack in a public place will receive push notifications, increasing the likelihood of two or more responders, who can encourage one another and even take turns administering CPR.

“I think this is really a perfect marriage of technology with a government service and volunteers who want to participate,” said Kahn. “Every minute lost dramatically decreases your chance of survival. Literally every minute counts.”

I asked Kahn about the medical savings associated with early response in terms of less long-term damage. He said more data is needed for such an epidemiological study. “If you get the patient to the hospital before significant damage, the chance that they would successfully recover obviously increases. This app would let you know. You can more likely get there faster than the fire department.”

CPR in Progress

To learn about CPR and AED training in your area, visit the AHA’s website.

For more information on the new application and an electronic press kit, visit the SRFPD’s website.

To download the SRVFPD’s app now, visit ‘Fire Department’ in the iTunes store.

Chief Price will be a guest on Gov 2.0 Radio on the evening of February 6, 2011, to discuss this new technology.

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15 Comments

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Profile Photo Chris Poirier

As a first responder I have mixed feelings about this type of application. The purpose of CPR certification for the layman is to provide people with a stop-gap life saving solution during the time period it takes for trained professionals to respond and take over. When you introduce an application of this type you are turning the lay-person into someone who is enabled to respond beyond the scope of just being a bystander. This comes with an amazing amount of responsibility and a potential of added legal burden that, that lay-person was not burdened with prior to the app. Just as much as the application shows people in need near by, from a legal perspective this app could be used to locate trained individuals that are near by that did not respond. This is an unintended consequence, however is a potentially very serious legal problem with such a concept. The beauty of CPR trained members of our society is the increased likelihood of potentially life saving capable person is nearby.

I feel this could be a situation where the technology now changes them from a Good Samaritan into what we call, “someone with a duty to act.” Once you have a duty to act applied to you, you must act legally if you are trained to provide life saving services. As part of this label, it means that if you are aware of a situation and you do not act you could be held liable for that persons life. (This is the reality that first responders deal with every day.)

I would recommend they have a very strict legal review of this application and how it could impact the good samaritan laws in the states it is offered as it could potentially cause more problems than it is designed to solve. Though I would also say that this type of application for first responders could be a very powerful tool or even in fixed facility based situations where on site response teams could get the geolocation of a situation.

Great concept, but with technology comes responsibility and quite often many unintended consequences.

Profile Photo Adriel Hampton

Chris, this was developed and reviewed by one of the best local fire dept’s in the country, and was released with full partnership of the International Association of Fire Chiefs. Out of hospital rates of survival are well below 10 percent for cardiac arrests, and only 30 percent of people get CPR.

It literally saddens me to see some of the responses of people with EMS backgrounds (see source of cynical comments on TechCrunch as well) to the incredibly innovation and trust in community and real desire to improve outcomes by the San Ramon Valley Fire Protection District.

I expect the same kind of things were said about CPR training of citizens, and of deployment of AEDs in public places.

More coverage from Radar.

Profile Photo Chris Poirier

With all due respect, I simply am providing for conversation a rather painful reality in this space of emergency first response and the involvement of semi-trained citizens. By no means was I intending to be overtly cynical, in fact I am a huge supporter of volunteers. (I have been a volunteer firefighter/EMT for nearly 12 years now.) However, a lot of the situations I outlined are very real issues that the first responder and public community needs to come to terms with in today’s litigation heavy world. To this end, given its limited distribution it highly possible that CA does provide more protections then most places under the Good Samaritan law, however I know quite confidently that it would not survive in most states. This is not an issue of “trusting the citizens” this is legal fact and at a minimum it would be in the best interests of everyone involved to provide that warning to citizens who intend on using the app that their position as a “good citizen” could be potentially upgraded simply by having and actively using the app.

Like a lot of applications and situations I have seen introduced of late, a really good idea at that, is implemented with a focus on the citizens while the root issue/problem is going ignored. The problem here is the lack of career trained first responders and/or volunteers. Recruitment and retention for these types of small public safety organizations is a massive problem in today’s America. However, the answer is not to arm the citizens with a tool that gives them all the emergencies and no training. The focus here should be on targeted recruitment, increasing the ranks of trained professionals at the department and/or other volunteer response organizations locally, and conducting public out reach overall.

To be fair, I’m not against public training for CPR and AEDs. In fact the introduction of AEDs in the public has done more for survivability rates then anything else in recent years, however these devices are quite literally “idiot proof” where as CPR is technique based. Another note for the sake of discussion is that layman issued CPR, though better than nothing, is only roughly 8%-15% effective and that is only if done properly. (Which many studies have shown is few and far between as it is a high stress situation. This is the primary reason that the layman version of CPR now no longer includes breathing for the victim, but just compressions.) Now, I’m not advocating that doing nothing is the best answer, but just to be fair with the stats I feel compelled to provide that statistic given the potential impact from legal discourse. Bottom line is that, advance medical care provided by paramedics and/or emergency room doctors is the only thing that statistically makes a difference in cardiac events. This is why most jurisdictions focus on response times and the ability to transport cardiac patients as quickly as possible. Just know that this is NOT a justification to do away with citizens who learn CPR and are willing to undertake administration, however it is only a stop gap solution, those interested in providing the best care to their fellow citizens I highly advocate signing up for an EMT-B course and joining a local rescue squad.

Citizen responders have become an ongoing issue for the fire/EMS/police services. Katrina, 9/11, and other mass casualty events have shown that people who want to help, but hold no training flock to disasters. This is dangerous and results in more victims in a disaster area. It is all well and good that people want to help, but it is best to push people towards formal volunteer organizations for training and involvement rather then empowering them as “self-responders” which seems to be the general feeling that this application gives me.

However, as stated previously, this application would serve a great deal to the department itself, off duty members, and other types of similar situations. Why must gov 2.0 tech be used to engage the public when the problem is the engagement of the civil services themselves? As stated, a goal for gov 2.0 this year should be problem solving at the root of the problem. Citizen engagement comes next and is a natural extension of this type of focus in application development.

Profile Photo Adriel Hampton

Chris, perhaps you didn’t notice that the app also provides the location of the nearest AED – devices that while available, often go unused. I suspect Joe Farrell, who’s both received and given CPR during sudden cardiac arrest would disagree with some of your statements. As might the career fire chiefs and heart surgeons who support this effort.

Katrina is an example of why we should leave all EMS work to trained professionals?

Discuss, sure, but provide solutions. How about extending Good Samaritan laws to communities that don’t have them? How do we increase CPR training so more communities have the high rates of trained community members that San Ramon enjoys?

Instead of writing more than 1,000 words about why this is a nice idea but has problems, I took the day off yesterday to help promote it, am learning CPR, and will be working to extend it to other communities.

Profile Photo Chris Poirier

Honestly I’m highly offended at this point you would suggest that my over 12 years of volunteer service to the people of Vermont, Maryland, DC, and Maryland and a volunteer first responder and consultant can be trivialized by your one day of good deeds and service. I am not suggesting that this isn’t a good thing, however like most things there are pros and cons and we must address both in order to be successful.

Katrina is an example of where thousands of unqualified self-responders showed up, got in the way, and became victims themselves causing more work for trained volunteers and career personnel that were on site. This is documented in multiple after action reports and part of why FEMA and DHS are advocating for credentialing of volunteers and career personnel. (When deployed outside their jurisdiction the commanders on the ground will know what they have at their disposal.)

I admire their goals in San Ramon, however this effort has largely gone unnoticed by the fire service writ large, not a single major publication mentioned the event or the app. There are reasons for this. Most career and volunteer personnel would agree with my assessment as we battle this battle every day. Everyone agrees that CPR is important, but there are more far reaching issues in emergency first response that could benefit here using the same technology. The app store even has other applications for first aid, hazmat operations, and fire operations calculations. These are GREAT steps towards helping those in need and are being passed around the professional periodicals between professionals because they impact their day to day operations.

Don’t get me wrong, this is a good move for a small community, but leaves much to be discussed if to be implemented. This is only ONE issue, I have many more, but it is clear there is no room for educated discussion on this point as you have already deemed it righteous.

Don’t ever question my dedication to people in my community or my country again, you don’t know me that well and simply because we disagree is no reason to suggest otherwise.

Profile Photo Chris Poirier

Alright, solution time:

1.) Consolidation of available volunteer organizations that provide general citizens disaster/emergency response training and organizational structures into a single application for membership validation. (e.g., Fire Corps, CERT, American Red Cross, State/local volunteer response/surge cadre, ARES, RACES, FEMA Disaster Response Cadre, local volunteer fire/ems/law enforcement) This is part of being NIMS compliant anyway, but is not being done well.

2.) Geo-location of capabilities like physical resources, personnel, command posts, triage locations, and logistical support stagging areas.

3.) Phone book/loop up of all of the above. Sort by volunteer org, certifications, skill sets, equipment, etc.

4.) Integrate all NIMS forms into application for deployment in the field.

5.) Geo-location reporting by volunteers of incidents, points of interest, and items mentioned above.

6.) Crowd source photos, videos, etc from volunteers for situational awareness.

7.) Provide push of important information to volunteers and public about incident/etc. (e.g., avoid this area, street closed, etc.)

As stated, the position of the local FD should be to get more people involved in programs like the Fire Corps, CERT, and their volunteer cadre. This allows citizens to get solid training and be integrated into their operations. The future “citizen soldier” if you will. Now take this app and provide it to those that are part of those volunteer cadres and you have a winner.

Profile Photo Adriel Hampton

Good solutions. No one is questioning your personal committment. I questioned your tone (which started out with a heavy legal critique I don’t believe you are qualified to give). Is the IAFC not a credible organization?

I work for local government, and it’s simply not going to get more money. I enjoyed learning about the improvements you suggest to emergency management, and agree we need coordination and increased numbers of trained volunteers.

Profile Photo Chris Poirier

It was a heavy critique, but also a lesson for those to consider. Seeing as I spent 8 years of academic research in emergency management, first response, security, and safety I would like to think I have something to offer on the topic. As a matter of fact the legal impacts of first responder actions is the entire first lesson for the National Registry Emergency Medical Tech. – Basic course tough nation wide and covers this legal concept at length. It’s drilled into every first responder. It’s food for though, we often move out on good ideas prior to looking at the impacts.

The IAFC is an outstanding organization, but they also support the concepts I spoke of. (It is of note they didn’t have a press release on the event their president was at. Probably worth passing along to the folks in San Ramon. Also, have them submit to Firehouse and Fire Engineering as I did not see any articles in those spaces.)

Money is exactly the problem, but showing the need for more trained personnel is a BIG problem for the nation’s public safety organizations. It’s part a marketing problem, which this type of tech would be HUGE for.

Profile Photo Adriel Hampton

Thanks for the tips – SRVFPD went with a traditional press embargo, which may have meant missing production cycles with some of the trade pubs.

And my apologies for the argumentative response – there were very cynical negative comments about the release on TechCrunch from anonymous people purporting to be EMS professionals, and I’ve unfairly conflated them with your reasonable comments.

Profile Photo Allen Sheaprd

Interesting app.

The idea sounds good. That while dialing 9-1-1 ( *always* the first response) one can say I’m here and need CPR/AED. Of course one does not *have* to be CPR/ADE trained to do CPR/AED. AED do walk laymen through the process.

Its also a math issue. Of the small fraction of us with Adult/child CPR/AED traiining, an even smaller number have an iPhone or Android. I own niether – nor do I have internet/WiFi on my phone.

Where this could be very helpful in on the highway. In a mall, gym, office or library people can see someone collaps. In a car on the road? Nope.

Sorry for being so negative.

Thanks for posting it.

Profile Photo Chris Poirier

Any time, I would be more than happy to help in any way I can to help push some of the concepts I mentioned below, etc. My goal is to help first responders, career and/or volunteer, do everything they can to help them in their daily lives. There are simply a lot of angles to a lot of these issues. In fact, I’d love for the IAFC to dedicate some resources to this type of thing, however they suffer from the funding issue as well.

I am sorry for my quick reaction as well, I tend to get defensive very quickly and can learn to cool down before going off. I highly respect the work you have done in Gov 2.0 and have been a follower/supporter for some time. I’d love to murder board anything and/or provide input on topics of this nature as I am very personally invested.

Profile Photo Allen Sheaprd

BTW – why dees every min count? two reasons.

Once blood fresh blood stops flowing to the brain can only hold out for about six (6) min before nerve damage occurs. Since brain matter does not grow back we are talking permanent and irriversable brain damage.

Second – once the heart goes in to B-Trac or V-Fib it wears itself out. Tires out just like any other muscle and then quits. Unfortunatly once the heart stops there is no blood flow to help it recover. Its a one way thing apperently.

Yes – CPR and AED make a difference. After about six or eight min there is less of a person to recover. Less for the doctors and EMS to work with.

Online American Heart Association CPR course: http://www.onlineaha.org/

Red Cross AED/CPR course locator: http://www.redcross.org/portal/site/en/menuitem.d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=aea70c45f663b110VgnVCM10000089f0870aRCRD&vgnextfmt=default

IMO – take a class course with at least 10 others. We all have different questions to ask and bits of information to offer.

Profile Photo Adriel Hampton

That is very good, and with a powerhouse like ESRI, it should get good tracking. I believe our SFDEM is up to speed, but they don’t do much with social so it’s hard to know unless you’re directly in their meetings.

To your 1), what would be great is merging volunteers into a geolocation app with badges for various certs, and the ability to handle alerts based on the those badges.

The million dollar question: Why is it so hard to get agencies and non-profits working more closely together?