abstract
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The intent of this report is to examine better ways for quickly finding automated external defibrillators - devices used to help restart the hearts of individuals suffering sudden cardiac arrests - by first responders when a cardiac emergency strikes.
More and more people are either witnessing or suffering sudden cardiac arrests. Automatic External Defibrillators (AEDs) have been proven to be vital in helping to save these individuals' lives through the act of defibrillation or simply 'shocking' the heart. Studies have shown that defibrillators are capable of saving lives cost effectively when they are made available in public places. The history of AEDs in Ontario is discussed, along with the current distribution of AEDs and operations of municipal Public Access Defibrillation (PAD) programs that work in collaboration with the Heart and Stroke Foundation of Canada. PAD programs oversee the distribution, placement, and maintenance of defibrillators in public places such as arenas, shopping malls, schools etc. The list of supported PAD programs continues to grow even as legislation supporting the mandate of distributing defibrillators and creating defibrillator registries is being enacted. The problem that arises now is to help individuals find these defibrillators quickly in situations where they observe someone having a heart attack.
Solutions to this problem that are examined in this research include: the City of Hamilton Public Access Defibrillation Program; a non-profit organization called First Aid Corps; Enhanced 911 emergency services; Location Based Services; and defibrillators with wireless communications for individuals who have no prior training in using these devices; and the creation of a browser based system.
These alternative solutions to help people find and use defibrillators have highlighted the fact that mobile communications technologies such as smartphones have platforms that could be adapted readily to locate defibrillators in emergencies. A possible smartphone solution that was examined in detail is the Apple platform. This platform was chosen for detailed study because Apple currently has the largest consumer market share and has the greatest number of applications available to run on its mobile devices. An application (or just plain "app") is a smartphone program which enables users to engage in a wide variety of online activities such as banking, finding restaurants, or even searching the Internet. This s study investigates the possibility of creating different versions of a smartphone application which could help people locate nearby defibrillators during a cardiac emergency.
The design, functionality and cost of several versions of the proposed smartphone application as well as other alternatives are evaluated. A cost analysis is done to rank what the researchers believe are the most cost efficient applications and alternative strategies. Challenges and opportunities are discussed to give a sense of the problems involved in developing, implementing, and maintaining an application of this type. The strengths, weaknesses, opportunities and threats are also laid out to demonstrate the potential of an AED finder application, and to indicate the direction that needs to be taken to actually implement a suitable reliable system. 2
These combined evaluations demonstrate that the creation of a smartphone app which aids in finding nearby AEDs is feasible. However, it would need to work in conjunction with existing Public Access Defibrillation programs in Ontario that are managed by municipal Emergency Medical Service (EMS) operations, since EMS operators are aware of the geographical coordinates of local AEDs. Providing AED location information maps and related instructions through smartphones would enhance alternative emergency 911 operator information for quickly finding nearby AEDs. Concurrently, public education programs and ongoing awareness campaigns about the availability of the smartphone solutions would need to be used to popularize their availability and enhance current education and training in the use of AEDs and CPR. These programs would give users the awareness and confidence in their ability to work as first responders in emergency cardiac arrest situations, not only with AEDs and CPR but also with mobile communications technologies.
The next phase proposed for this work is to develop an application and work with Hamilton Ontario EMS services to conduct a pilot study that assesses the usefulness, feasibility and effectiveness of such an application for the growing population of smartphone users who may be faced with such emergencies.
The final study conclusions indicate that there are numerous possibilities for combining health interventions such as defibrillators with new mobile communications technologies, and that this combination promises· solutions that will help first responders to find nearby AEDs and save the lives of people undergoing cardiac arrest.