Making CPR More Accessible: Part 2

More than 350,000 people go into out-of-hospital cardiac arrest (OHCA) each year in the United States.¹ For those who do, what happens next — specifically, whether or not they receive bystander cardiopulmonary resuscitation (CPR) before paramedics arrive — can be a critical factor in their likelihood of survival.² As we saw in part 1 of our series on CPR accessibility, we’ve come a long way when it comes to the expansion of lifesaving CPR skills beyond medical professionals alone.

But improving the rate of bystander CPR is still an uphill battle. According to the American Heart Association (AHA), in one survey only half of Americans said they would perform lifesaving CPR if they witnessed a cardiac arrest.³ The other half wouldn’t know how to respond, would be afraid of injuring the victim, would assume someone else would step in, or some combination of the above.³

The good news: Technology may be able to help. In this blog, we will cover 4 technologies that have the potential to improve bystander CPR and defibrillation rates.

Smartphone alert systems

For OHCA victims, the period between when the arrest occurs and when paramedics arrive is critical. But whether or not they receive lifesaving CPR in this interval often comes down to sheer luck: Who is in the immediate vicinity when the cardiac arrest occurs? Do any witnesses step in to perform CPR, or are they hesitant to act?

Smartphone alert systems help cast a slightly wider net in the hopes of getting the right people to the scene. They can take advantage of widespread smartphone use, geolocation technology, and community volunteer databases to notify people who are nearby and trained in CPR that a cardiac arrest has occurred.⁴

Wearable devices and remote monitoring

Wearable devices (e.g., smart watches) are another popular technology that can potentially be leveraged to improve bystander CPR response. For example, these devices can monitor vital signs and provide feedback on the effectiveness of CPR.⁵ Studies have even shown that smart watches may help improve accurate compression depth.⁵

Importantly, as we learned in our interview with an emergency medicine physician,  wearable sensors may also have the potential to help victims of unwitnessed cardiac arrests. For example, they might be used to notify automated external defibrillators (AEDs) in the area, or even alert 911 directly when a cardiac arrest occurs.

Lastly, remote monitoring systems can enable healthcare professionals to assess the progress of resuscitation and provide guidance in real-time, improving the quality of care delivered by bystanders.⁶ This kind of real-time support and guidance would also likely make bystanders feel more comfortable to step in and perform CPR, which is crucial to increase bystander involvement.

Social media

Increased public awareness and education are essential to improve rates of bystander CPR. This includes making the public aware of the risk of sudden cardiac arrest, teaching them to recognize the signs, and equipping them with skills to perform CPR and use an AED when needed.

Of course, there are multiple ways to better educate and spread the word: public service announcements, increasing access to basic life support (BLS) training, etc. But social media can also be used alongside these other strategies to rapidly disseminate information and engage communities in CPR training. For example, social media platforms could be used to⁷:

• Share instructional videos on CPR
• Connect people to resources (e.g., upcoming BLS training in their community)
• Encourage active participation in CPR preparedness
• Share stories of OHCA survivors and the importance of bystander CPR

Drones and apps to increase AED access

Early AED use for OHCA victims is associated with higher survival rates.⁸ In fact, for those with shockable rhythms, the likelihood of survival decreases with each minute that defibrillation is delayed.⁹ It’s no surprise then that one of the AHA’s priority areas identified in the recently published 2030 goals is to increase the percentage of victims who have an AED applied before paramedics arrive.

But even in circumstances where bystanders feel comfortable and prepared to apply an AED, accessing one can present obstacles. This is especially true in remote areas where an AED might not be available, but it can happen anywhere if bystanders don’t know where the nearest one is located. Fortunately, there are a couple ways technology innovations may be able to help:

• Simulation studies have shown that drones equipped with AEDs are possible and can allow for quick delivery of these devices to the scene. This solution has the potential to help overcome geographical barriers to AED access, particularly in remote areas.⁸
• Mobile apps or web-based platforms can also provide real-time information to bystanders to locate the nearest AED. Apps could take advantage of user-friendly features like navigation assistance¹⁰ to cut down on the time it takes to locate the AED, which is essential in a medical emergency like cardiac arrest where every second counts.