The gift of life is in your hands

Posted: Sunday, September 9, 2012

The last thing Robert Berue remembers before he died is sweeping freshly mowed grass clippings off the front porch of his Middletown home.

His third heart attack — which turned into cardiac arrest — happened on a sunny Saturday morning in June as some neighbors were outside on their lawns only a few doors away and unaware of what was happening.

That no one rushed to perform CPR before the paramedics arrived and revived him is something that doesn’t surprise Berue, who turned 50 in August.

After all, last year he watched his neighbor die in front of his house after he suffered cardiac arrest. As with Berue, the emergency medical responders performed CPR and revived his neighbor.

“I think a lot of people are scared of CPR,” Berue said.

That is true, said Dr. Gerald Wydro. He is regional medical director of Bucks County Emergency Health Services and one of the rescue workers who treated Berue at the scene of his cardiac arrest.

Historically, bystander-CPR rates in the northeastern United States have been “very, very” poor, despite a national effort by the American Heart Association to promote hands-only CPR over the traditional mouth-to-mouth version, he said.

Using hands-only CPR alone can double, even triple, the survival rate for a person who experiences an out-of-hospital cardiac arrest, Wydro said. And it only takes five minutes to learn.

That’s why Wydro is starting a campaign to boost awareness of hands-only CPR.

As part of it, he hopes to get Bucks County government to consider participating in a free PulsePoint smartphone application that directs people to public areas where someone is experiencing a cardiac arrest so they can assist until rescue workers arrive. The app would have to be integrated into the county’s 911 emergency system, which could cost the county, he said.

Wydro is set to meet later this month with county officials, including the director of emergency management and the director of the county’s emergency radio room, to discuss the possibility of implementing the app here.

Cardiac arrest occurs when normal blood circulation stops because the heart doesn’t contract effectively. A heart attack can progress into cardiac arrest, a condition that kills about 350,000 U.S. adults a year, making it among the nation’s leading causes of death.

Two out of every three cardiac arrest deaths happen outside a hospital. Every minute a patient is in cardiac arrest, the chance of survival drops roughly 10 percent.

Bucks County rescue squads respond to an average of about 285 out-of-hospital cardiac arrest calls a year and about 15 percent of patients have a pulse rate returned by the time they arrive at the hospital, Wydro said. The county doesn’t collect data on how many of those patients survive and how many are discharged without brain damage.

“But without a doubt, those numbers are much lower than 15 percent,” he said.

A life in their hands

Bucks County has already taken steps to encourage bystander CPR. The Bucks County radio room dispatchers will tell people who call in a suspected cardiac emergency to perform hands-only resuscitation until rescue workers arrive.

“If they’re not in cardiac arrest, they’re going to push you away,” Wydro said.

He believes that a combination of better awareness of the hands-only CPR option and the PulsePoint smartphone app could boost survival rates here as it has in other areas where the app is available.

The app uses the GPS-capabilities in smartphones to link emergency medical dispatches with people near a cardiac arrest event. People who download the free app to their phone can be alerted when someone near them requires CPR.

Currently, four areas are “live” on PulsePoint: the San Ramon Valley, Alameda County and San Jose in California and Erlanger Kentucky, according to Rob Burne, PulsePoint’s chief executive officer.

San Jose is the largest U.S. city to utilize PulsePoint’s location-aware technology, which is available on both the iPhone and on Android-enabled phones. The San Jose Fire Department and the nearby El Camino Hospital partnered to bring the technology to the community.

The only cost associated with the app involved integrating the app technology into the existing 911 software, said Richard Price, fire chief for San Ramon Valley Fire Co., which has used the PulsePoint app since 2011. While he estimated that could cost up to $20,000, he said local sponsors, such as hospitals, may cover that cost.

At the moment, PulsePoint developers have no “hard facts” regarding app responders because it doesn’t track any information on the users, victims or their location, Burne said. But PulsePoint hopes that will change with a new app update that will add an anonymous follow-up survey on phones that have received a CPR alert, Burne said.

What Burne can say is that the app has been downloaded and installed by more than 25,000 individuals and it has issued 89 CPR alerts matching the criteria of a likely cardiac arrest in public locations with responders who have the app and close enough to assist.

San Jose Fire Department spokeswoman Capt. Mary Gutierrez said that the nearby San Ramon Valley Fire Department collects all information about the alerts and she has had been told they get “quite a few” citizens responding to calls almost every week.

“There are typically good Samaritans that are already on scene when the event occurs,” she said.

San Ramon Valley Fire Chief Price says the PulsePoint app has created a greater public interest in CPR and public access to automated external defibrillators. He said that 17,000 citizens in his area are now trained in hands-only CPR. Plus, the fire department is looking at doing one-minute training videos on hands-only CPR that will be featured on TV gas pumps.

And Price said he’s seeing more bystanders using the lifesaving skills.

Arriving emergency responders now find as many as six people at CPR alert locations, he said.

And where rescue workers once would find someone performing CPR at the scene only one-quarter of the time, they’ve found bystanders doing so 40 to 50 percent of the time over the last two years, he added.