Help Cocreate First Aid Corps

1. The Next (Anti-)Killer App Start Date 07.07.07

3. 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. 1 1 1 1 Outcome of CPR in a Large Metropolitan Area – Where are the Survivors? Becker LB et al Ann Emerg Med 1991;20:355-61 3 3 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 2 2

4. 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 CPR 1 2 3 4 1 2 3 4 Cardiac Arrest and Resuscitation Epidemiology in Singapore ( CARE 1 ) Study Dr Marcus EH Ong et al PreHospital Emergency Care 2003;7:427-433

6. 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

7. Before First Aid Corps CPR NO CPR 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 * * Quality-Adjusted Life Year

8. With First Aid Corps (CPR only) CPR NO CPR 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

9. With First Aid Corps (CPR + AED) CPR + AED NO CPR or 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

10. With First Aid Corps (CPR + AED) CPR + AED NO CPR or 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

11. Solution (Activation Phase) Caller in Distress 500 metres GIS/WiFi-enabled cellphones and notebooks indicate volunteers’ locations. Activated Activated Activated Activated Activated GPS-enabled Ambulance Activated Activated

12. 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

13. 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

14. 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

15. Why Now? 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 Advanced Cardiac Life Support in Out of Hospital Cardiac Arrest Ian G Stiell et al N Engl J Med 2004;351:647-56 1 1 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 2 2 1 3 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 3

16. 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 1 2 2 1,

17. 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 1 1

18. 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

19. Cocreators,we need your help! [email_address]