Abstract 292: Non-Arrest PulsePoint Activations In Public And Private Settings

Abstract

Objectives: Geospatial “smart” technology such as PulsePoint is increasingly used to crowdsource community response for suspected out-of-hospital cardiac arrest (OHCA). Although the clinical focus of this strategy is OHCA, dispatch identification is imperfect such that activation often occurs for the non-arrest patient. The frequency and clinical profile of such non-arrest patients has not been well characterized. Methods: Prospective 3-year cohort investigation of patients for whom the PulsePoint was activated for suspected OHCA in four United States communities (total population ~1 million). We evaluated those patients with a PulsePoint activation for suspected OHCA who were subsequently not found to be in cardiac arrest on arrival. The response cohort included off-duty, volunteer public safety personnel (verified responders) notified regardless of location (public or private) as well as laypersons who were only notified to public locations. We linked the PulsePoint information with EMS records to report the frequency, condition type, and EMS treatment for these patients. Results: Of 1779 calls where volunteers were activated, 756 were OHCA, which left 1023 non-arrest patients for evaluation. The most common EMS assessments were syncope (15.9%, n=163), altered mental status (15.5%, n=159), seizure (14.3%, n=146), overdose (13.0%, n=133), and choking (10.5%, n=107). These findings were similar for private and public locations. The most common EMS interventions included placement of an intravenous line (43.1%, n=441), 12-Lead ECG (27.9%, n=285), naloxone administration (9.8%, n=100), and airway or ventilation assistance (8.7%, n=89). Conclusions: More than half of patients activated for suspected OHCA by PulsePoint in both public and private had conditions other than cardiac arrest. A subset of these conditions may benefit from earlier care provided by both layperson and public safety volunteers if they were appropriately trained and equipped.