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The Next (Anti-)Killer App Start Date 07.07.07

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Page 1: Cocreate First Aid Corps

The Next (Anti-)Killer App

Start Date 07.07.07

Page 2: Cocreate First Aid Corps

Case StudyState of Arizona

113,635 square miles

Population 5.9 million

Population Density 45.2 persons per square mile

Demographics 13% above 65 years old

The Save Hearts in Arizona Registry and Education (SHARE) program : Who is performing CPR and where are they doing it?

Tyler Vadeboncoeur et al

Resuscitation 2007

November 2004 to April 20061097 cardiac cases total

65 cases per month67% occur in residences

Survival Rate 3.3%

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Page 3: Cocreate First Aid Corps

Survival Rates in Other States

Courtesy of Take Heart America

Columbus, Ohio 6.5%

St Cloud, Minnesota 8.5%

Austin, Texas 10.4%

New York City 1.4%

Chicago 1.3%NATIONAL AVERAGE 6-7%

Estimated 250,000 deaths/year outside hospital.

More than 40% deaths potentially preventable.

Generally 2 out of every 3 cases occur at home.

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Outcome of CPR in a Large Metropolitan Area – Where are the Survivors?

Becker LB et al

Ann Emerg Med 1991;20:355-61

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Outcome of Out of Hospital Cardiac Arrest in New York City : the Prehospital Arrest Survival Evaluation (PHASE) Study

Becker LB et al

JAMA 1994;271:678-83

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Page 4: Cocreate First Aid Corps

Global Problem

Singapore 2% 13.8%

Ontario, Canada 2.5% 14.5%

UK 2% 15%

Japan 3.5% 28.4%

Circumstances of Out of Hospital Cardiac Arrest in Patients with Ischemic Heart Disease

RM Norris et al

Heart 2005;91:1537-1540

An Outcome Study of Out of Hospital Cardiac Arrest using Utstein Template – A Japanese Experience

K Mashiko et al

Resuscitation 55(2002) 241-246

Circumstances, Community Response, Role of Prehospital Defibrillation and Predictors of Survival

Brison RJ et al

Can Med Assoc J 1992;147:191-199

Survival Rates Bystander CPR1

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Cardiac Arrest and Resuscitation Epidemiology in Singapore ( CARE 1 ) Study

Dr Marcus EH Ong et al

PreHospital Emergency Care 2003;7:427-433

Page 5: Cocreate First Aid Corps

Public Use of Automated External Defibrillators

Sherry L Caffrey et al

N Engl J Med, Vol 347, No. 16

Early CPR and AED in Closed Environment

Chicago O'Hare AirportJune 1999 – May 2001

11 out of 18 who had sudden cardiac arrest were rescued with public AEDs and discharged well from hospital.

55% of successful rescues were done by the public who had no training on AED use before.

Page 6: Cocreate First Aid Corps

Aim of First Aid Corps

3.3% Survival 60% Survival

“GPS modernization translates to more lives saved and faster recovery for victims of global tragedies.”

National Space-Based Positioning, Navigation and Timing Coordination Office

Page 7: Cocreate First Aid Corps

CPR NO CPR

Before First Aid Corps

Victims

Bystanders

$406,605 per life saved / $225,892 per QALY (1996 US$)Cardiopulmonary Resuscitation : What Cost to Cheat Death?

Lee KH et al

Crit Care Med 1996;24:2046-52

Cost-Utility Analysis

*

*Quality-Adjusted Life Year

Page 8: Cocreate First Aid Corps

CPR NO CPR

With First Aid Corps(CPR only)

Volunteer

Victims

Bystanders

$243,963 per life saved / $135,535 per QALY (1996 US$)

Provision that volunteer is notified and attends to 60% of victims.

Subscribers Non-Subscribers

Page 9: Cocreate First Aid Corps

CPR + AED NO CPR or AED

With First Aid Corps(CPR + AED)

Volunteer

With

AED

at Work

Or

Home

Victims

Bystanders

$7,100 per life saved / $44,000 per QALY (1996 US$)

Subscribers Non-Subscribers

Potential Cost-Effectiveness of Public Access Defibrillation in the United States

Graham Nichol et al

Circulation 1998;97:1315-1320

Page 10: Cocreate First Aid Corps

CPR + AED NO CPR or AED

With First Aid Corps(CPR + AED)

Volunteer

With

Roaming

AED

In

Car

Victims

Bystanders

$9,200 per life saved / $27,200 per QALY (1996 US$)

Subscribers Non-Subscribers

Potential Cost-Effectiveness of Public Access Defibrillation in the United States

Graham Nichol et al

Circulation 1998;97:1315-1320

Page 11: Cocreate First Aid Corps

Solution (Activation Phase)

Caller in Distress

500 metres

GIS/WiFi-enabled cellphones and notebooks indicate volunteers’

locations.

Activated

Activated

Activated

Activated

ActivatedGPS-enabled Ambulance Activated

Activated

Page 12: Cocreate First Aid Corps

Activated

Activated

Activated

Activated

Activated

Activated

1 min

3 mins

4 mins

5 mins

4 mins

2 mins

9 mins

Solution (Response Phase)

Activation via Independent Network

Activation via Current Dispatch Network

Page 13: Cocreate First Aid Corps

Potential Technical Solutions (?bypass dispatch centre to shorten time of response)

Internet

?Digital Network

Callers in Distress Dial 911

Volunteers notified via GIS/WiFi-Enabled Cellphones

and Online Messages on Location of Distress Caller thro maps and addresses

Page 14: Cocreate First Aid Corps

Sustainability Model

Certified & motivated volunteers recruited.

Family members gets automatic coverage.

Media coverage on success stories.

Volunteers get world recognition.

Volunteers follow up on survival victims, document better results ASAP.

More Lives Saved.Public and Governments’ Support

Page 15: Cocreate First Aid Corps

Bystander CPR is now known to be the most important factor for survival and good quality of life after out-of-hospital cardiac arrest.

Recent results of bystander CPR and AED use are better than results from support from emergency medical services.

Recent results show that long-term survival among patients is similar to that among age-, sex- and disease-matched patients who did not have out-of-hospital cardiac arrests.

Victims of cardiac arrest are more likely to receive CPR when the event is witnessed by bystanders unknown to the victim than if the arrest is witnessed by friends or family.

Odds Ratio of Survival

Bystander CPR Only 3.7

Early Defibrillation 3.4

EMS Advance Life Support 1.1

Why Now?

Advanced Cardiac Life Support in Out of Hospital Cardiac Arrest

Ian G Stiell et al

N Engl J Med 2004;351:647-56

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Long-Term Outcomes of Out of Hospital Cardiac Arrest after Successful Early Defibrillation

T Jared Bunch et al

N Engl J Med 2003;348:2626-33

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A comparison of cardiopulmonary resuscitation rates of strangers versus known bystanders.

Casper K et al

Prehosp Emerg Care 2003 Jul-Sep;7(3):299-302

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Page 16: Cocreate First Aid Corps

Why Now?

Emerging evidence is showing that chest compressions alone (CCR) is equal or better than conventional CPR with mouth to mouth ventilation.

Bystanders will be more willing to perform CCR without fear of transmitted diseases like AIDS and Avian Influenza.

Japan

Cardiocerebral Resuscitation Improves Survival of Patients with Out of Hospital Cardiac Arrest

Michael J Kellum et al

Am J Med 2006;119:335-340

Cardiopulmonary Resuscitation by Bystanders with Chest Compression only (SOS-KANTO):an Observation Study

SOS-KANTO Study Group

Lancet 2007;369:920-6

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21,

Page 17: Cocreate First Aid Corps

Why Now?

The use of the automated external defibrillators ( AED ) in public and private places has been gaining momentum since its introduction a decade ago.

Time between collapse to defibrillation is the second most important factor to determine survival to survival and good quality of life after out-of-hospital cardiac arrest.

Advanced Cardiac Life Support in Out of Hospital Cardiac Arrest

Ian G Stiell et al

N Engl J Med 2004;351:647-56

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Page 18: Cocreate First Aid Corps

WWW.FIRSTAIDCORPS.ORG

FIRSTAIDCORPS.ORG will be used for registration of accredited volunteers from the respective states and countries.

FIRSTAIDCORPS.ORG will be venue of information sharing and forum.

FIRSTAIDCORPS.ORG will show real-time locations of distress worldwide.

FIRSTAIDCORPS.ORG will be platform for worldwide recognition of the men, women and children who exhibit courage and bravery in their deeds as members of the corps.

“To the world you may be one person, but to one person you may be the world.”Anonymous

Page 19: Cocreate First Aid Corps

Cocreators,we need your help!

[email protected]