App Makes Bystanders Key in Cardiac Arrest Survival

Heather Caspi details the mobile app that's catching fire in cities around the country to help cardiac arrest victims.

Citizens in a growing number of cities around the U.S. are now getting alerted when there’s an opportunity to perform bystander CPR, thanks to the PulsePoint phone app.

The Technology

The free app, which notifies trained citizens of nearby cardiac emergencies and the location of the nearest AED, was originally developed and tested by the San Ramon Valley (Calif.) Fire Protection District. It works by connecting a participating agency’s dispatch data into the PulsePoint service so that citizen alerts go out simultaneously with the dispatch of local fire and EMS resources. (Citizen alerts only go out for cardiac emergencies in public places, not to private addresses.) The app shows the victim and the nearby AEDs on a map, in context to the recipient of the alert.

The app has had several updates and releases since it first launched.“The app is in a continuous update cycle,” said San Ramon Valley Fire Chief Richard Price. “We’re working on a major new version right now.”

In February, after the program had been running locally in San Ramon for over a year, the PulsePoint Foundation opened it up to other agencies.  It has quickly spread in California and nationally.

“By the end of the month we expect it to be in more than 100 cities,” explained Price, who is also the president of the PulsePoint foundation.

The largest city currently operating the program is San Jose, Calif. and its surrounding area, which covers more than a million citizens. Soon Los Angeles and L.A. County will be added, which cover a total of about 10 million citizens. The cities onboard from beyond California include Sioux Falls, S.D., several cities in Oregon, and soon Honolulu, Hawaii.

“Cardiac survival is a numbers game,” Price noted, so the more citizens are covered under the program, the more people should survive sudden cardiac arrests (SCAs). Currently the numbers are grim; survival rates nationally for SCA are less than 8 percent, and it kills nearly 1,000 people a day, according to the stats at

The Success

The app has been activated more than 500 times since it launched, and it is now getting activated up to several times per day, Price said. The number will continue to grow as more cities get onboard.

Price noted that SCA victims may have about 10 minutes to survive, and that brain damage can occur within 4 to 6 minutes. “It’s an excruciatingly short opportunity to intervene,” Price said. “It’s hard for even the best systems to make an impact in that window of time.” This is where bystanders, or citizen rescuers, come in, and why it’s so valuable to increase the number of available “bystanders” to anyone in the area, not just those who witness the event.

People can watch on Twitter ( to see the live app activations and how many people are notified per incident, which depends on how many of those who are signed up for the service are within the locally prescribed response radius. (The app aims to notify those within walking distance, but the exact response radius is configurable by each agency. Those with higher population densities usually select a smaller radius, while those with low densities and longer EMS response times may choose to notify over a broader area.)

Price said that normally, professional responders to cardiac arrests find bystander CPR in progress only about 25 percent of the time. In San Ramon, that number is now approaching 50 percent, and there are often multiple citizen responders found on scene. When extra citizens respond, “we see bystanders able to rotate providing compressions and we have even found people clapping to 100 beats per minute,” Price said. “The app really reinforces the practices we’ve been teaching through public outreach, such as deploying a publicly-accessable AED and starting chest compressions quickly.”

SCA survival rates in the San Ramon Valley Fire District have jumped to 46 percent, and officials credit the PulsePoint app, along with several other best practices implemented throughout the agency and the community, for the increase.

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