Cocreate First Aid Corps
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Transcript of Cocreate First Aid Corps
The Next (Anti-)Killer App
Start Date 07.07.07
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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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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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
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.
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
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
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*Quality-Adjusted Life Year
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
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
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
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
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
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
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
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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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,
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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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