You’ve gone into cardiac arrest.
With every minute that passes without resuscitation, you’re 10 percent less likely to survive. After 5 minutes, your odds are cut in half.
Paramedics with the Bend Fire Department take an average of 8 minutes to show up, so your life may hinge on the off-chance a nearby Good Samaritan knows CPR.
If you live in Bend, that chance may increase as soon as this summer. The Bend Fire Department is implementing a smartphone app called PulsePoint, which syncs with the local emergency dispatch to automatically alert volunteers within close range to start CPR on a cardiac arrest patient before the ambulance arrives.
Steve O’Malley, Bend Fire’s deputy chief of emergency medical services, said the department in recent years has stepped up its handling of cardiac arrests — recording data and reviewing each case, examining its protocols against American Heart Association guidelines — and part of that means allowing the public to get involved.
“What this does is it gives legs to people that are public-safety minded, that are altruistic, that would like to help their fellow man,” he said. “It just kind of gives a really tangible way to make that happen.”
Once PulsePoint’s software is synced with emergency dispatch, those who download the free app receive an alert on their phones any time there is a report of a cardiac arrest within a half-mile from them. (Cities can set their own distances. Urban areas usually go with a quarter-mile.) The alert is automatic, so 911 dispatchers don’t need to press any more buttons than usual. The cardiac arrest also must happen in a public place in order for the alert to go off.
The app, which requires GPS to be enabled on the phone, directs the volunteer to the patient and to the nearest automated external defibrillator, or AED.
Mark Charleston, EMS battalion chief with the Tualatin Valley Fire and Rescue, said he’s found it’s rare for a cardiac arrest to happen in a public place with people nearby who’ve downloaded the app. His is the only agency in Oregon that has fully implemented PulsePoint so far.
“The likelihood is pretty small, but we’re actually catching a number of people and alerting them,” he said.
Although Charleston’s department responds to a couple hundred cardiac arrests per year, only three calls have had volunteers report to the scene since the agency implemented the program one year ago this month, he said.
The first case happened when a nurse was leaving a dental appointment and performed CPR on a patient who had gone into cardiac arrest in the parking lot. When paramedics arrived, they realized the patient had a “do not resuscitate” order, so they stopped working on the patient, who died.
The second instance occurred in a grocery store, but the patient hadn’t actually gone into cardiac arrest. In the third case, the ambulance arrived at the same time as the volunteer, Charleston said.
Still, Charleston said, the response to PulsePoint has been “fantastic.” Almost 7,000 people have downloaded the app, he said.
More than 500 agencies around the country have activated PulsePoint in their communities, and at least 75,000 people have downloaded the app to their smartphones, said Richard Price, president of the PulsePoint Foundation.
In the cities that use PulsePoint, it’s been activated more than 2,000 times and about 6,000 volunteers have received alerts, said Price, retired fire chief for the San Ramon Valley Fire Protection District in California.
Price said he did not have data on the proportion of people who responded to the alerts, but said about 30 percent of people who download the app tend to actually report to incidents after receiving an alert.
Although the app is intended to be downloaded by people who are CPR-certified or have had some training, PulsePoint doesn’t have a process of vetting those who use it.
The AHA’s CPR training certifies health professionals for two years at a time, but the association also has developed a hands-only course for laypeople, who also can attain the two-year certification if they choose. The shorter, one- to three-hour course doesn’t result in CPR certification, but students do receive cards indicating they’ve taken it, said Amber Hossick, CEO of Code Ready in Bend, which provides CPR and other health response training.
Several people interviewed said they weren’t concerned about the fact that anyone with a smartphone can download the app.
Charleston said people warned his office about the potential for crowds to gather around cardiac arrest patients just to gawk, but said that hasn’t been a problem.
Greg Boivie, a clinical educator at St. Charles Madras who teaches CPR courses, said he wouldn’t worry, either. It’s more important just that someone performs CPR, he said.
“I would hope that if somebody downloads the app, they’re not downloading it just so they can say, ‘Oh gee, someone needs CPR. I’m going to run over and watch,’” Boivie said.
Performing CPR on people also is very unlikely to harm them. On the contrary, it could save their lives, he said.
“The thing I remind people is the fact that if you’re needing to do CPR, they’re dead,” he said. “You can’t hurt something that’s dead.”
The bigger problem, experts say, is oftentimes those who are trained get too nervous to actually perform CPR.
Nationally, more than 60 percent of people who have responded to incidents after receiving PulsePoint alerts have been off-duty medical personnel, such as nurses or police officers, O’Malley said.
That’s why Charleston said he’s trying to engage the public in the roughly 440,000-resident area that Tualatin Valley Fire and Rescue serves to make people feel more comfortable doing hands-only CPR.
In 2010, the AHA reviewed data on cardiac arrests and realized would-be volunteers were intimidated by the dozens of steps involved in performing CPR properly. The organization then released simplified guidelines that recommend a hands-only approach involving fewer steps and only chest compressions without mouth-to-mouth resuscitation.
Price, of PulsePoint, said CPR training today is simple: both hands on the chest at the nipple line, 100 compressions per minute at a depth of 2 inches.
“Our fear is not really that people who aren’t trained in CPR will do CPR, it’s sort of the opposite,” he said. “CPR takes a lot of courage. When we train people, will they have the courage to do CPR when they’re trained? We try to reinforce that it’s simple and the professionals are on their way to back you up.”
Research shows people also are more likely to perform CPR — and higher-quality CPR — when more bystanders are around to help. That’s because it’s actually a strenuous activity, and peoples’ skills tend to decline after 2 minutes of performing CPR, said Hossick, of Code Ready.
The success of PulsePoint also depends on how many people in a community are CPR trained or certified. It’s impossible to get an accurate count of CPR-certified people in Bend, as several different entities provide certification locally. Cody Ready trains more than 3,000 people annually and St. Charles Health System trains another 2,500 each year.
But PulsePoint certainly isn’t cheap, O’Malley said. Implementation costs about $12,000. That includes an estimated $7,000 to build a software interface between the emergency dispatch service and a $5,000 annual fee.
In the end, O’Malley said he thinks it will be worth it for Bend. He has confidence that locals — so many of whom are current and retired health professionals — will step up to the challenge.
“If you really pose the question to most people, ‘If you have a GPS-enabled smartphone, why would you not try to do this?’” O’Malley said. “You have the opportunity to possibly save a person’s life.”
— Reporter: 541-383-0304,