The PulsePoint Study

June 28, 2023 updated by: Dr. Steven Brooks

Evaluating the PulsePoint Mobile Device Application to Increase Bystander Resuscitation for Victims of Sudden Cardiac Arrest

This randomized controlled trial will evaluate whether use of the PulsePoint system increases bystander CPR or defibrillator use compared to standard dispatch procedures in patients who suffer non-traumatic, out-of-hospital cardiac arrest in a public location. Half of all suspected cardiac arrest 9-1-1 calls in a public location will receive PulsePoint alerts (treatment arm). The other half of this eligible patient cohort will receive standard dispatch procedures (control arm).

Study Overview

Detailed Description

Out-of-hospital cardiac arrest (OHCA) is a major public health problem. More than 45,000 Canadians suffer OHCA annually, with only 8.4% surviving to hospital discharge. Early bystander cardiopulmonary resuscitation (CPR) and defibrillator use can save lives but are rarely done.

Advances in mobile device technology have allowed the development of a system which can notify CPR-trained citizens within 400 meters of a possible cardiac arrest. The PulsePoint mobile device application (www.pulsepoint.org) empowers them to respond and provide basic life support while professional crews are being dispatched. When a mobile device receives the alert data from the PulsePoint system, the application presents a map showing the exact location of the emergency and the closest public access defibrillator.

PulsePoint will be implemented in 3 regions across Canada and the US (British Columbia, Winnipeg, and Columbus, Ohio). After a coordinated marketing campaign in each participating region to maximize the number of mobile device application downloads in the community, 9-1-1 calls for suspected cardiac arrest will be randomized to conventional dispatch for suspected cardiac arrest versus conventional dispatch plus PulsePoint notifications. The primary outcome will be bystander CPR or defibrillator use prior to professional responders arriving on scene. The primary analysis will involve comparing outcomes between the control and treatment groups among randomized patients who satisfy inclusion and exclusion criteria and have at least one PulsePoint responder within 400 meters of the cardiac arrest event.

The investigators hypothesize that the PulsePoint system will have an immediate impact on increasing bystander CPR and defibrillator use in participating communities. In the long term, this project will provide valuable data on how effective PulsePoint is with respect to bystander resuscitation and survival. The data will directly inform policy decisions about PulsePoint implementation in the participating communities and guide other North American jurisdictions around these policy decisions in the future.

Study Type

Interventional

Enrollment (Estimated)

522

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • British Columbia
      • Vancouver, British Columbia, Canada, V5M 4X6
        • Recruiting
        • British Columbia Emergency Health Services
        • Contact:
        • Sub-Investigator:
          • Sandra Jenneson, MD
        • Sub-Investigator:
          • Jennie S. Helmer, M.Ed.
    • Manitoba
      • Winnipeg, Manitoba, Canada, R3B 1J1
        • Not yet recruiting
        • Winnipeg Fire Paramedic Service
        • Contact:
        • Sub-Investigator:
          • Rob Grierson, MD
        • Sub-Investigator:
          • Erin Weldon, MD
    • Ohio
      • Columbus, Ohio, United States, 43207
        • Recruiting
        • Columbus Division of Fire
        • Contact:
        • Sub-Investigator:
          • Ashish Panchal, MD, PhD
        • Sub-Investigator:
          • Robert Lowe, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Patients with 911 calls assigned as "suspected" or "confirmed" cardiac arrest and,
  2. Are confirmed to be EMS-treated, public location out-of-hospital cardiac arrest.

Exclusion Criteria:

  1. Traumatic cardiac arrest, or
  2. Cardiac arrests occurring in the context of a dangerous scene as determined by the 9-1-1 call-taker, or
  3. EMS-witnessed cardiac arrest, or
  4. Cardiac arrests not treated by EMS ("Do Not Resuscitate", signs of obvious death), or
  5. Cardiac arrests occurring in nursing homes and health care facilities.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Conventional Emergency Dispatch PLUS PulsePoint notification
Eligible 911 calls randomized to the experimental arm of the study will undergo usual dispatch of emergency services personnel as per pre-existing local protocols and activation of the PulsePoint system. When triggered, the system will push location data to all PulsePoint mobile application users within 400 meters of the emergency. Devices receiving the alerts from the PulsePoint system will alarm with auditory, tactile and visual stimuli. The application will present a map showing the exact location of the emergency and the closest public access defibrillator.

The PulsePoint interface software monitors each 9-1-1 call on dispatch computers and is automatically triggered by particular conditions including call type (e.g. suspected cardiac arrest) and location type (public location). When triggered, the system pushes location data to all PulsePoint mobile application users within 400 meters of the emergency location.

When a mobile device running the PulsePoint Respond application receives the alert data from the PulsePoint system, the device alarms with auditory, tactile (vibration) and visual stimuli. The application presents a map showing the exact location of the suspected cardiac arrest and the closest public access defibrillator.

No Intervention: Conventional Emergency Dispatch
Patients randomized to the control arm will receive conventional emergency medical dispatching procedures as per pre-existing local protocols (e.g. dispatch of emergency vehicles, attempted dispatch-assisted CPR) without activation of the PulsePoint system. 911 calls randomized to the control arm will not be associated with any PulsePoint alerts.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of patients receiving bystander resuscitation
Time Frame: Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Defined as the occurrence of either bystander CPR (chest compressions and or ventilations) or bystander application of a defibrillator prior to the arrival of emergency medical services.
Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of patients receiving bystander CPR (secondary effectiveness outcome)
Time Frame: Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Defined as the occurrence of bystander CPR (chest compressions and or ventilations) prior to the arrival of emergency medical services.
Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Proportion of patients receiving bystander defibrillator use (secondary effectiveness outcome)
Time Frame: Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Defined as bystander application of defibrillator pads on the chest of the victim prior to the arrival of emergency medical services.
Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Proportion of patients receiving bystander defibrillator shock delivered (secondary effectiveness outcome)
Time Frame: Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Defined as the occurrence of a bystander applying an automated external defibrillator and then applying a defibrillatory shock to the chest of the victim.
Patients will be followed for this outcome during the interval from 9-1-1 call to emergency medical services arrival, an expected average of 5 minutes.
Proportion of patients with return of spontaneous circulation (secondary effectiveness outcome)
Time Frame: Patients are followed from EMS arrival on scene until arrival at hospital, an expected average of 35 minutes.
Defined as any palpable pulse or measurable blood pressure.
Patients are followed from EMS arrival on scene until arrival at hospital, an expected average of 35 minutes.
Proportion of patients surviving to hospital discharge (secondary effectiveness outcome)
Time Frame: Patients are followed until death or discharge from hospital, an expected average of 30 days.
Defined as survival of a patient to the point of discharge from the acute care hospital. Discharge may be to a residence or long term care facility.
Patients are followed until death or discharge from hospital, an expected average of 30 days.
Proportion of patients surviving to hospital discharge with good functional outcome (secondary effectiveness outcome)
Time Frame: Patients are followed until death or discharge from hospital, an expected average of 30 days.
Defined as the occurrence of a patient surviving to hospital discharge with a Modified Rankin Score of 0,1, 2 or 3.
Patients are followed until death or discharge from hospital, an expected average of 30 days.
EMS response time interval (secondary safety outcome)
Time Frame: Expected average of 5 minutes.
Defined as the time interval between the 9-1-1 call and the EMS arrival on scene.
Expected average of 5 minutes.
EMS on scene time interval (secondary safety outcome)
Time Frame: Expected average of 30 minutes.
Defined as the time interval between the EMS arrival on scene to EMS departure from scene.
Expected average of 30 minutes.
Proportion of patients receiving bystander interference with the resuscitation effort (secondary safety outcome)
Time Frame: Patients will be followed for this outcome in the time interval between 9-1-1 call and EMS departure from scene, an expected average of 35 minutes.
Defined as emergency medical service crew reports of bystander interference with the resuscitation effort.
Patients will be followed for this outcome in the time interval between 9-1-1 call and EMS departure from scene, an expected average of 35 minutes.
Number of PulsePoint application downloads (secondary system performance outcomes)
Time Frame: Downloads in the participating communities will be tracked for the duration of the anticipated 2 year patient recruitment time frame.
Defined as the number of PulsePoint application downloads in each participating community.
Downloads in the participating communities will be tracked for the duration of the anticipated 2 year patient recruitment time frame.
Number of PulsePoint application users notified (secondary system performance outcome)
Time Frame: This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.
The number of application users notified for each PulsePoint notification.
This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.
Sensitivity of PulsePoint activation (secondary system performance outcome)
Time Frame: This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.
The sensitivity of the PulsePoint activation as it relates to activation for true cardiac arrests.
This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.
False positive rate for PulsePoint activation (secondary system performance outcome)
Time Frame: This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.
The false positive rate for PulsePoint activation resulting from activation of the system for conditions other than cardiac arrest.
This will be tracked for each notification event that occurs during the anticipated 2 year accrual time frame.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Steven C Brooks, MD MHSc, Queen's University
  • Principal Investigator: John M Tallon, MD MSc, University of British Columbia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 8, 2021

Primary Completion (Estimated)

September 30, 2024

Study Completion (Estimated)

March 30, 2025

Study Registration Dates

First Submitted

March 16, 2021

First Submitted That Met QC Criteria

March 16, 2021

First Posted (Actual)

March 19, 2021

Study Record Updates

Last Update Posted (Actual)

July 3, 2023

Last Update Submitted That Met QC Criteria

June 28, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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