If the heart stops beating... A mobile application helps saving the lives of thousands of people

The author of the project "20 Ideas for the Development of Russia" Dmitry Davydov proposes to introduce the experience of saving the "heart patients" in Russia as well. And this requires legislative support. Let's take a look at the points that are necessary to implement this idea in practice.

Viktor Levin

HOW MANY PEOPLE DIE FROM HEART ATTACKS

To begin with, it is worth explaining the scope of the problem.

Cardiovascular diseases, despite the rapid pace of development of medicine, remain the main cause of death both in the world and in Russia, Russian Minister of Health Mikhail Murashko said in September 2021.

"Despite the high level and rapid pace of development of world and domestic medicine, cardiovascular diseases remain the leading cause of morbidity and mortality throughout the world and in the Russian Federation", - Murashko said at the scientific and practical conference "Cardiology on March 2021".

Diseases of the circulatory system (CVD) traditionally occupy the first place in the structure of mortality in Russia, currently accounting for 47%. According to the National Medical Research Center (NMRC) them. V.A. Almazov, in 2020, 944,843 people died from diseases of the circulatory system, which corresponds to 643.9 cases per 100,000 people.

It is no secret that a significant number of "heart patients" die as a result of acute attacks and out-of-hospital cardiac arrest, when it is impossible to provide emergency care. However, there are chances of saving at least some of the people.

WORLD EXPERIENCE IN PRE-MEDICAL REANIMATION

Automated external defibrillators (AEDs) have proven effective in many developed countries. These are portable devices placed in public places and available to anyone who has witnessed a heart attack and wants to provide first aid. This does not require special medical skills, since the device itself detects cardiac arrest and produces the desired effect.

Dmitry Davydov analyzed the practice of using defibrillators within the framework of the project "20 Ideas for the Development of Russia". The first study on the effectiveness of AEDs in the US and Canada in 2005-2007 showed that the use of defibrillators by bystanders increased the chance of survival by several times: in 38% of cases where an electric shock was given before the arrival of an ambulance, patients survived. Experts estimate that about 1,700 lives a year are saved in the United States today through the use of AEDs by bystanders.

It is important to note that the appearance and use of AEDs not by medical specialists, but by volunteers became possible due to the adoption of relevant laws and regulations. The use of the AED by any resident is already legally permitted, in particular, in 13 European countries and in the vast majority of US states.

RUSSIA IS NOT STAYING OUT OF PROGRESS

Few people know, but in June 2021, the State Duma of the Russian Federation adopted in the second reading a bill on the placement of automatic defibrillators in public places: airports, railway stations, stadiums and metro stations.

It is proposed to allow an unlimited number of people to use automatic defibrillators installed in public places to provide emergency medical care (now only certain categories of medical workers are allowed to use automatic defibrillators - ed.).

According to the standards existing in Russia, the placement of ambulance stations should be carried out taking into account the 20-minute transport accessibility. At the same time, with defibrillation in the first 3 minutes from the moment of the incident, the survival rate is about 70%, after 10 minutes (the average time of arrival of the ambulance service team) - no more than 10%.

“Given the principles of operation of automatic external defibrillators (AEDs), their use is absolutely safe for both the victim and the person using them,” cardiologist Sergei Kovalev told NI. “After all, modern AEDs are a portable device that automatically diagnoses potentially dangerous for the life of cardiac arrhythmias, on the basis of objective data, independently makes a decision on the need for defibrillation and then can stop the corresponding life-threatening arrhythmia by supplying an electrical discharge of the required power.

This completely eliminates the possibility of both erroneous and accidental or deliberate electrical defibrillation, experts say. However, it must be added that the presence of AEDs in public places is not enough; we need people who are aware of this possibility and are ready to personally save other citizens, and a mechanism for informing volunteers about this or that emergency.

MOBILE APP: THE EXPERIENCE OF SINGAPORE SHOULD BE FOLLOWED BY RUSSIA

As for volunteers, their number in Russia has been constantly growing since the late 1990s.

Currently, Russian volunteers are united by such large organizations as the Association of Volunteer Centers (since 2014; more than 200 thousand volunteers work on a permanent basis), Victory Volunteers (since 2015; 159 thousand), Medical Volunteers ( since 2013; 12.5 thousand), the Union of Volunteer Organizations and Movements (since 2009; more than 7 thousand), etc.

1,546 organizations are registered on the information platform "Volunteers of Russia". Thus, there will be no shortage of caring people.

But a special mobile application will help inform them.

"Singapore's experience is interesting in this matter", - the author of "20 ideas for the development of Russia" Dmitry Davydov is sure.

In 2015, the Singapore Ministry of Home Affairs Citizens Protection Service announced the development of a special mobile application that allows users to receive notifications of the need for emergency assistance nearby. The collaboration goes like this:

1. As soon as the rescue service registers a case of sudden cardiac arrest, users within a radius of 400 meters from the scene are instantly notified with the exact coordinates.
2. In addition to the description of the location, the application also displays the nearest available AEDs that are installed throughout the country.
3. If the user decides to respond to the notification and provide assistance on the spot, he makes a corresponding mark in the application.

Of course, the application tracks the geolocation and sends notifications only if the user has voluntarily turned on the active mode. The app contains training materials on how to perform CPR and use the AED, as well as answers to frequently asked questions. The user must pass identity verification and study the instructions for assistance. Thus, each resident has the opportunity to become a volunteer in cases of out-of-hospital cardiac arrest, providing resuscitation procedures before the arrival of emergency services, and thereby increasing the chance of rescue.

By April 2018, the application had been installed 80,000 times and 1,700 users responded to cardiac arrest notifications and provided the necessary assistance. Based on its successful track record of engaging citizens in the fight against an immediate threat, the Singapore Rescue Service expanded the functionality of the application, allowing volunteer users who are nearby to participate in extinguishing small fires before the arrival of the fire brigade.

We propose in Russia, simultaneously with the entry into force of a new law that allows providing first aid during cardiac arrest, to launch a mobile application similar to that in Singapore, which will speed up the start of resuscitation. The development of the application can be carried out on the basis of government information systems and will not require significant investments, Dmitry Davydov is sure.

It is also proposed to promote this application in the media as part of the social advertising quota, promoting the idea of the importance of joint efforts to fight the number one killer in society - sudden heart attacks. Thus people will be involved in emergency care, and survival after cardiac arrest will increase significantly.