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Smartphone apps for first aiders: rescuers on call


In cardiac arrest, every second counts. Smartphone apps can help to mobilize first aiders quickly. In Germany, however, this has not yet been organized uniformly.

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Essential for survival: First responders and accessaries care for a collapsed person

Photo: Philips

Every year at least 50,000 people in Germany suffer a sudden cardiac arrest outside of a hospital, so completely surprisingly at home, at work or on the go.

If someone suddenly collapses on the street, on the bus or at work, help is needed quickly.

In such cases, the time is measured in seconds;

After only three to four minutes without life-saving measures, the victims are threatened with permanent damage.

Everyone who gets a driver's license learns in the obligatory first aid course how to perform chest compressions in such an emergency.

But the inhibition threshold is high to apply what you have learned in an emergency.

The situation of suddenly having to provide first aid is overwhelming for many of those affected, both physically and mentally.

Therefore, only around 40 percent of people start chest compressions when they find someone who is unconscious, report specialists.

But by the time the rescue service is on site and the professionals start resuscitation and ventilation, it often takes more than the critical three to four minutes to pass, because on average the rescuers need nine minutes to arrive.

In more and more counties, the rescue workers are hoping for smartphone apps that will shorten this time.

If an unconscious person is reported by emergency call, the dispatcher in the rescue control center alerts potential first aiders in the area, who can rush to the scene of the accident and provide first aid there until the rescue service arrives.

The principle has been around for years

Such applications have been around for a long time.

From 2013 the Gütersloh district was the pioneer.

The initiator there was the neurosurgeon and emergency physician Ralf Stroop, who only noticed when the rescue workers arrived that an emergency had occurred in his immediate vicinity that he could have helped - if he had found out about it.

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If an alarm is received, a first aider has 30 seconds in the Katretter app to confirm his or her mission

Photo: c't

Over the years, other systems have been added that all work on the same principle.

In Freiburg, for example, the association "Region der Lebensretter" was founded in 2017, which took over an existing system from Denmark and adapted it to its own needs.

Since the districts organize the rescue service individually, there are no standards so far, and such systems are by no means in use everywhere.

The alerting and selection of potential first aiders run in the districts according to different rules and with different priorities, if there is such an app at all.

The Arbeiter-Samariter-Bund (ASB), for example, focuses its work on a register for publicly accessible defibrillators that can be accessed by anyone via an app.

Only medical specialists or rescue service personnel with current qualifications for first aid can be registered as emergency helpers for the ASB system.

In October of this year, the Fraunhofer Institute for Open Communication Systems (Focus) published such an app solution called Katretter.

The name is based on the institute's established Katwarn population warning system, which is already in use in numerous rescue control centers.

It would be particularly easy for the districts that are already using Katwarn to establish such a solution.

Right at the beginning, Berlin and seven other districts were there, another 30 are, according to Focus, in concrete discussions about the introduction or are already making preparations.

In the so far only few locations, 2,000 alarms were issued via the system, in 750 cases rescuers were actually able to deploy.

3,000 first aiders are already registered in Berlin.

Small states

Although the Fraunhofer system works nationwide, the rescue control centers remain independent of one another.

If a registered first rescuer in Berlin is traveling in a district who also uses Katretter, he will not be alerted, because the rescue control centers already proceed differently when selecting potential rescuers.

In some places it is sufficient to have attended a first aid course for registration, elsewhere the operators require that you have at least basic medical knowledge in order to participate, or even only allow professionals from medicine and rescue services to be potential first aiders.

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The planned helper function from Katretter is already visible in the app, but not yet implemented

Photo: c't

The operators of Katretter respond to this by introducing two categories of helpers, first aiders and accessory workers.

The helper function has not yet been implemented, but the point is already visible in the app.

Focus is currently implementing this function in the app together with the Berlin fire brigade and the ASB.

Rescuers can, for example, help by securing an accident site, instructing rescue workers or bringing an automatic defibrillator from a nearby location for the first responder.

You're already further in Freiburg.

The system there assigns four first aiders whenever possible.

Each of these is given a specific task: the first two take turns doing the chest compressions, the third helper fetches the nearest defibrillator and the fourth helper ensures that the emergency service arrives quickly to the scene.

Privacy issues

The exact location of the participants is essential for the focus app to work.

However, it would not be justifiable under data protection law to monitor this constantly.

For this reason, Fokus has chosen a two-stage approach.

In normal operation, potential helpers are only roughly located.

The location is only updated every 500 meters if you are in motion, otherwise every 5 minutes.

The location is then artificially distorted by another 500 meters in the system.

This no longer allows conclusions to be drawn about the exact whereabouts.

As soon as the alarm occurs, however, accuracy is required.

In this case, the location of all potential first aiders is recorded with what is known as fine localization and evaluated for the alert.

At the end, only the status reports and operational documentation are saved.

When the alarm goes off, the helper has 30 seconds to take the job.

He then receives the exact location where his help is needed and sets off.

Only a few seconds pass between the triggering of the alarm by the dispatcher and the receipt of the message by the helper.

Most of the time is spent updating the location data.

According to Focus, the messages themselves are sent within one to two seconds.

If the first alarm is unsuccessful, the system goes through the alarm twice, because the situation could have changed in the meantime, for example because a participant has left an underground car park and has reception again or accidentally came close to the emergency site on his way.

In some rescue control centers, first aiders are alerted by default in the event of a possible cardiac arrest, while elsewhere the dispatcher can manually activate or deactivate the alarm according to his assessment.

Many solutions

Similar to the warning apps for the population, there are different technical solutions for the first-aid apps depending on the district, but ultimately all of them work according to the same functional principle.

Many people do not stay in one district all the time, but commute, are often on the road for work or have two places of residence.

A uniform standard with networking between the app operators or a nationwide platform could literally save lives by enabling more first aiders.

Learn about first aid apps

Icon: The mirror

Source: spiegel

All tech articles on 2021-01-23

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