What an AED Is, and Where to Find One

Ed's Note: The AHA has declared a goal to reduce deaths from cardiovascular diseases and stroke by 20% by 2020 and issued a challenge for startups and small teams to build innovative apps and devices to improve cardiovascular outcomes and reduce readmissions. Ten finalists are participating in 30-day campaigns on the medical crowdfunding site, Medstartr. Three winners will be chosen based on funds raised, number of social shares and votes from a panel of expert judges, and will receive funding totaling $25,000 and have the opportunity to present at the American Heart Association’s Health Sciences Innovation Investment Forum on March 6, 2014. The iRescU AED location project is one of the finalists. EMS World profiled this project in 2011. Read more below and visit Medstartr to donate to the project and receive key chains, t-shirts and more.

As important as bystander CPR is to saving victims of witnessed sudden cardiac arrest, there are sure a lot of impediments to making it happen. A bystander has to be willing to act, know what to do, recall it under pressure, perform it competently, and keep it up until definitive help arrives. We have no way to make people act. Everything else, we can help them with. Smart-phone apps are a great tool to that end; they offer everything from basic CPR directions to performance measurement and feedback.

iRescU will go a bit further. It's an app being developed by a global interdisciplinary team of experts in emergency care, public health, media technology and interface design as a sort of "one-stop shop" app for CPR training, emergency use, AED location and data collection.

"The iRescU app will not only help train you in CPR and support you if you have to do it, but it's also designed to help you locate any AED that's nearby," says Nadine Levick, MD, MPH, head of the EMS Safety Foundation, which is working to bring iRescU to market. "To date, the only way to know where AEDs are is if you've actually mapped them in your area."

The location capability comes courtesy of the First Aid Corps (www.firstaidcorps.org), a Singapore-based coalition devoted to improving SCA survival rates. One of the Corps' projects is crowd-sourced AED mapping. Its AED Nearby (iPhone) and ShowNearby AED (Android) apps let users find the closest AED to their location, and add locations of new ones not yet mapped, thus creating a perpetually growing global database.

iRescU will combine that ability with performance measurement and feedback, the first app to do so.

"Doing CPR is great, but you're going to have to get that AED," notes Levick. "We're stuck with this reality that AEDs have been manufactured, built and sold without a consistent way of knowing where they're located. You could be doing CPR on one side of a wall, and on the other side of the wall have an AED and not even know it's there."

The benefits of such an app could be numerous. On the training side, instructional, performance-measuring apps can be a cost-effective alternative to imparting skills in the traditional classroom setting (and IRescU will be free) and can help keep skills honed over time. In an emergency, such apps can help ensure a recipient gets compressions at the right rate and depth, and that rescuers don't forget key aspects or push incorrectly. The location capability, meanwhile, facilitates the speedy defibrillation needed to zap the dys- out of a dysrhythmic heart. And iRescU will additionally call 9-1-1 and store event data for EMS use and contribution to cardiac arrest databases.

The Tools People Know

Beyond the specific capabilities of iRescU or any app, there loom larger questions about educating people and how well the healthcare industry really communicates its messages to the public. When presenting iRescU for the first time at last year's mHealth Summit--a gathering of practitioners and those interested in mobile and wireless health applications--Levick says she was actually asked what an AED was.

"That took me a little by surprise," she says. "But you know, maybe someone who does, for instance, nutritional analysis of food might not know what an AED is, even though they're in healthcare. It's a powerful statement about how limited our outreach to the broader community has been."

The distributive nature of something like iRescU or the FAC's apps might represent a solution to that. It can bring familiarity and accessibility with things like CPR and AEDs to citizens' pockets and purses by making them part of the solution, not just talking at them about the solution.

The notion also taps the power of social media. It's interactive, it's easy, and it's tech-forward--theoretically, things to which newer generations of learners and consumers will respond.

"With the way we've approached CPR and medical education, to a large degree, crowd sourcing and social media and those avenues have not been exploited in the way they could be," says Levick. "CPR training is not very hip. The sorts of things that would make it interesting to young people aren't there. We want to be sort of funky and eye-catching and attractive in a way that's going to appeal to people in the community, rather than just healthcare providers. If the challenge is to reach out into the community, we have to use the tools people know and understand."

Pilot Testing

The iRescU app is around 1 megabyte in size and works on multiple mobile platforms. Additional features include international local language capability; infant, child and adult resuscitation guidance paths; adherence to AHA/European Resuscitation Council guidelines; low-light visibility; and EMS handover prompts.

For more information, see www.irescu.info.