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The application has three primary components – the mobile app, a middle tier web service, and a dispatch system interface.
The mobile app is provided and maintained by the PulsePoint Foundation. Apps are currently available for the iPhone and iOS device platform and Android devices. One version of the software (on each platform) supports all agencies using the app (there is not a separate app for each agency). A configuration screen within the app allows users to select their desired agency or agencies. Member agencies can also provide a connection to local radio traffic to enable a streaming radio feed within the app.
The middle tier is a (Amazon EC2) cloud-based web service that manages communications between the personal mobile devices and the emergency communication centers of member agencies. The service provides encrypted communication and secure identification (HTTPS with SSL/TLS protocol) to connected agencies within a highly reliable environment. This service is also provided and maintained by the PulsePoint Foundation.
Emergency communication centers communicate with the middle tier service through an application programming interface (API). An API is simply a set of rules and specifications that software programs can follow to communicate with each other. The PulsePoint API serves as an interface between Computer-aided Dispatch (CAD) systems and PulsePoint services.
The first step is to build consensus for the app in your community. Determine who should be involved in such a decision and assemble them to discuss the matter and ask questions. Typical attendance might include representatives from Fire, EMS, Communications, Information Technology, Public Information/Outreach, Leadership/Elected Officials, Labor, and affiliated non-governmental organizations such as the local heart association chapter, hospital board/foundation, etc., in addition to interested members of the community. You should also contact your Computer-aided Dispatch vendor at this point to begin discussing the interface requirements and any associated costs. If the vendor has already installed the interface in other accounts this should be a straightforward request. If they haven’t, contact our implementation partner, Physio-Control, and they will provide assistance in getting them the support they need to get up and running on the service.
The application also requires data on all publicly accessible AEDs in your jurisdiction. If this information is dated or incomplete, now is the time to consider fully re-validating these records. PulsePoint provides a powerful, easy-to-use visual registry to accurately place each AED at its precise location. Agencies using other databases such as Atrus can simply share AED location information with PulsePoint.
Once your organization has made the decision to move forward, contact Physio-Control for complete assistance along the path to a successful implementation.
The costs associated with implementing PulsePoint vary depending on agency size and dispatch environment. Agencies should plan for expenses in the three categories highlighted below. The foundation and our implementation partner, Physio-Control, can help you develop a precise budget for your organization.
Project Management and Community Outreach
For the app to be successful in any agency it must be embraced by the community. Effective implementation requires a comprehensive community outreach strategy to be planned and executed. Our implementation partner, Physio-Control, provides resources for the effort including a customized Public Service Announcement and extensive collateral advertising material. However, additional budget should be considered for an effective focused campaign of this nature, and Physio-Control can assist you in determining your budgetary needs. Due to the life-saving nature of the application, donated ad placement and other in-kind services are also possible.
The combined fee for 40 hours of project management and all community outreach resources is $6,500 per Public Safety Answering Point (PSAP).
Due primarily to an increase in awareness, a wide-scale campaign around the app will likely create a spike in demand for local CPR and AED training. Additional resources needed to support this surge should also be anticipated.
The PulsePoint Foundation is a small non-profit with a very big mission – a mission too big to accomplish alone. The vision to increase cardiac arrest survival rates in a massive way worldwide is an effort that requires collaboration with other organizations, such as Physio-Control, that share our vision. Such strategic relationships allow the PulsePoint Foundation to meet growing demand without incurring many of the overhead costs associated with marketing, implementing and supporting the PulsePoint app on a worldwide basis.
The partnership allows the foundation to focus on current and future versions of the app and associated products while offering PulsePoint agencies the broad and comprehensive services of a leading developer of emergency response tools.
The Health Insurance Portability and Accountability Act (HIPAA) protects the privacy of individually identifiable health information. On a ‘CPR Needed’ notification, the app reports only an address (in a public place) and a business name, if available. Individually identifiable health information, such as name, birth date, or Social Security Number are not reported or known to the PulsePoint application. In addition, PulsePoint has retained Page, Wolfberg & Wirth, LLC to assist agencies understand legal issues related to the implementation of PulsePoint. PWW is well respected EMS law firm specializing in dispatch liability and HIPAA issues.
The PulsePoint app is a Location-Based Service (LBS) with the ability to make use of the geographical position of your mobile device. The LBS capabilities of the app allow you to see your current location relative to the incidents occurring around you. This is an optional feature that is not enabled by default – you must specially opt-in to utilize this functionality. In addition, if you opt-in to the CPR/AED notification, the PulsePoint server will store your current location for immediate reference during an emergency where you may be nearby. In this case, only the current location of your device is stored (no movement history is maintained) and your identity is never known to the PulsePoint application.
CPR today is very easy to perform and can be learned quickly in informal settings such as community street fairs, group training sessions, take-home DVD-based courses, or even by watching brief online videos. These types of training environments do not provide certificates of other forms of skill documentation. Automated External Defibrillators (AEDs) actually require no training to use. Therefore, there is no ability or even reason to verify that someone volunteering to help others with CPR or an AED has been formally trained. Learn how you can help save a life in this one-minute American Heart Association video showing Hands-Only CPR in action.
A CPR notification arrives as a normal push notification similar to the one shown in the lefthand image below. This push notification will be accompanied by a distinctive alert tone. Opening the notification will load the PulsePoint app to the screen shown below on the right. This screen will display your current location, the general reported location of the cardiac arrest victim, and any nearby Automated External Defibrillators (AEDs). You can tap an AED icon for a text description of its precise location.
To receive a CPR Needed activation you must have the CPR notification type selected in the Settings Menu and you must be in the immediate vicinity of a reported cardiac arrest. Notification radiuses vary by jurisdiction.
You can play a sample of the alert tone below.
Only about a third of Sudden Cardiac Arrest victims receive bystander CPR, and public access Automated External Defibrillators (AEDs) are used less than 3% of the time when needed and available. The current situation is far too few bystander rescuers – not too many. The goal of the app is to engage additional bystanders in these lifesaving acts. If this situation was to truly materialize in the future it would be a major success and the footprint of the notification could be reduced.
How do you prevent someone from using the CPR/AED notification to steal from or otherwise take advantage of a cardiac arrest victim?
For the app to be activated someone must first call the local emergency number (such as 911) to begin a normal public safety response. This means that the victim is likely not alone when the CPR/AED notifications are made. In addition, the app is only activated for incidents occurring in public places (not at someone’s home for example) furthering the likelihood that others will be present. Also, since the app is only activated on devices in the immediate vicinity of the victim, a “Bad Samaritan” has little opportunity to be in the right place at the right time.
The app aims to notify those essentially within walking distance of the event location. However, this distance is configurable on an agency by agency basis. Higher population densities usually warrant a smaller notification radius. Likewise, a rural area with longer local government response times may choose to notify over a broader area.
The push notification services used by PulsePoint are provided by Apple on iOS devices and Google on Android devices. While these services are quite reliable they do not guarantee that every message will be delivered. Several factors beyond their control can also effect message delivery. Below are the primary factors that exclude a device from receiving an alert.
The purpose of the Good Samaritan Law is to protect individuals that assist a victim during a medical emergency. Most Good Samaritan laws are created specifically for the general public. The law assumes that there is no medically trained person available to assist the victim. Since the Good Samaritan typically does not have medical training, the law protects him or her from being liable from injury or death caused to the victim during a medical emergency. A general layperson is protected under the Good Samaritan laws as long as he or she has good intentions to aid the victim to the best of his or her ability during a medical emergency. Since each state law has specific guidelines, and this text does not provide a worldwide view of this matter, you should familiarize yourself with the laws or acts applicable to you. A typical example of the wording appears below.
Yes. With dispatchers making rapid over-the-telephone assessments of patients based on the observations of untrained callers, an incorrect determination can be made. For example, such a situation could occur with someone who has just had a grand mal seizure, passed out from too much alcohol, or has a very high blood sugar. However, if you tried to do CPR on such an individual he or she would probably moan and possibly even try to push you away. Also, an AED would not deliver a shock to a person in any condition where an effective heartbeat was present.
The application first checks with the originating agency, as this is the most accurate source of local information of this nature. It does this by checking the value of the “Public” field sent in the interface (API) record for the incident. An agency can set this value to True if it is able to determine this through the computer-aided dispatch (CAD) system, a GIS layer, local database, etc. For example, if the CAD system of the local agency knows that the incident address is at a local park, it can inform PulsePoint, through the interface, to consider the location as public. Likewise, if CAD can determine that the address is an apartment building, it can set the value of “Public” in the interface to False. If the value of “Public” is left blank, PulsePoint will query public data sources such as the Residential/Commercial Indicator (RDI) from the USPS (PulsePoint uses the USPS address validation API from SmartyStreets) along with other sources such as the Google Places API to make this determination.
Each agency supplies their own audio feed for use in the app (or can choose to use an existing public feed if available). Originating an official agency feed requires about $700 in hardware and a free account on RadioReference.com. See complete setup instructions on our Streaming Radio Channel page. Streaming radio feeds are optional.
The profile page allows PulsePoint agencies to easily display incident, event, station, apparatus, and other photo albums from within the app. See complete setup instructions on our In-App Agency Photos page. Including photos on the profile page is optional.