A suburban Portland fire district has a valentine for potential heart attack victims. And if it makes hearts un-flutter, you could see the messages shared more widely across the region and country in coming years via a lifesaving smartphone app.
Tualatin Valley Fire & Rescue Tuesday announced the expanded use of the app called PulsePoint, which crowdsources trained bystanders to start CPR when someone nearby calls 911 because of a sudden cardiac arrest. The app takes advantage of the location tracking feature in smartphones, provided the incident is in a public place.
But TVF&R Division Chief Brent VanKeulen said 80 percent of out-of-hospital cardiac arrests happen in private settings.
"We didn't want to have a crowdsourced app that just sent any person that could sign up and download the app and check a box (that they knew CPR) into people's homes,” he said.
The solution VanKeulen's department landed on is to invite only off-duty professional firefighter-EMT's to respond to residential PulsePoint alerts. About 200 staffers have signed up for a new, specially-tailored version of the app so far. The Philips electronics company is loaning every one of those vetted responders a portable defibrillator to shock stopped hearts, also known by the acronym AED.
Tualatin Valley Fire & Rescue has partnered with King County Emergency Medical Services to study the survival rates under different response scenarios.
In Seattle, King County EMS Medical Director Dr. Tom Rea said a quicker first response could make a crucial difference when every second counts.
"As time ticks by the chances of survival go down substantially -- five to ten percent per minute,” Rea said. “So the goal is really to get that CPR and get that AED to the patient who suffered cardiac arrest as quickly as possible. Even a very good EMS system like here in Seattle takes a few minutes."
Rea said he is hopeful other fire districts will copy the suburban Portland cities if the two-year study shows a measurable difference from scrambling the off-duty first responders to cardiac arrest calls.
911 dispatch centers in major Northwest cities have integrated PulsePoint over the past three years and area fire departments already credit it with saving lives. The Portland-Vancouver-Salem metro area and Spokane County were the first communities in the Pacific Northwest to implement it.
PulsePoint has since spread to Oregon's Jackson, Lincoln, Deschutes and Linn counties as well as Washington's Kitsap and Whatcom counties and the City of Seattle.
Spokane Fire Department Assistant Chief Brian Schaeffer said in his area, about 150 times per year the app triggers an alert to citizen responders within a quarter-mile of an incident. In 2016, PulsePoint activated 198 citizen responders to 62 reported cardiac arrest events in Tualatin Valley Fire & Rescue's service area.
The pilot project to expand bystander CPR alerts to private spaces using "verified responders" will take place across the 11 city territory of TVF&R, including Beaverton, Tigard, Tualatin, and Wilsonville, Oregon.
VanKeulen said Tualatin Valley was chosen in part because it had worked out insurance, labor union support and liability issues. The fire department already has a policy to pay firefighters and provide workers compensation coverage when they encounter and respond to an emergency while off-duty.
"Essentially once they decide to respond, either through the PulsePoint app or they come across a car crash in the community, we instantly put them on the payroll and they are like a firefighter getting paid to respond," VanKeulen said. "It is kind of hard to find a reason, I think, to say no to it."
VanKeulen said he is particularly interested to see study results on the human elements. He noted that cellular phones aren't always in earshot and to respond to an alert is a voluntary decision.
"What are the human behavioral factors? We decided to go. We decided not to go," VanKeulen said. "For the community, what was it like to have somebody that is dressed in plainclothes show up with an AED and ask to help at your home when you dialed 911? All of those different nuances are what we will be really exploring over the next several months."
PulsePoint is a free app available for Apple and Android phones. Anyone who feels comfortable performing CPR can sign up for alerts to come to a stranger's aid in public locations.