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      Sweden Has a Solution for Slow Ambulances

      October 23, 2013
      Mike Pearl

      By Mike Pearl

      Night Editor


      Image via

      When someone in Stockholm falls into cardiac arrest, the ambulance might show up a few minutes after the nearest person with a cell phone and a CPR certificate. This is a good thing.

      If your heart stopped right now and you were in the United States, here's what would happen: You would slump over, dropping the phone you're reading this on. If you're near someone, they would need a second to freak out, then, hopefully call 911, at which point an ambulance would be dispatched. By now, it's safe to say a minute has passed since your heart stopped.

      That's about a quarter of the four to six minutes you have before your brain starts dying. If the ambulance is already in your neighborhood, they might get there in time to start CPR. Is that likely?

      That is very unlikely. How about eight minutes if you're lucky? There are no federal laws regulating how long ambulances should take to get to you because if there were, the ensuing cases would clog up our courts. Agreements exist between regional governments and EMT companies, but the wordings are arcane: "Eight minutes or less 90 percent of the time," meaning it's not a crime if they take ten minutes, by which time you could be a vegetable. In crowded parts of Southern California, it's "12 or 15 minutes 90 percent of the time," by which time you're a goner. And that time quote isn't alarmist exaggeration., it's how Corey Haim died. Medical wisdom holds that every minute your heart's not beating, your chances of survival drop by 10 percent.

      In short, the whole ambulance thing just isn't for people whose hearts have stopped. It's not that the drivers are lazy. They're just human. They're just like you when you're in a hurry, navigating city streets while trying to work a GPS, except they can go through all the traffic lights.

      Like with pretty much everything else, Sweden has a better idea.

      The Karolinska Institute, the medical school where a committee gives out the Nobel Prize for medicine every year, created a system called "SMSlivräddare," or "SMS Life Savers." When an emergency dispatcher in Stockholm gets a cardiac arrest call, this experimental city-wide program dictates that they send an ambulance, and also a mass text to all program volunteers in the vicinity of the offending heart.


      via Google Maps

      The volunteers who receive the message have previously signed up and proved that they are qualified to perform CPR. Once alerted, they'll receive directions and information. Generally the cardiac arrest is within a half mile.

      A Swedish Redditor, username Dalecarlian, is a volunteer who described what it's like to get an assignment:

      "I got a phone call from a number I didn't recognize at 10pm. A robot said "there has been a cardiac arrest in the vicinity. You'll get the address via text message." Next came a text with the address, the name it said on the door, and a Google maps link.

       

      I hesitated for 10-30 seconds because it was so late. My girlfriend said, "Just do it." I imagined being unable to sleep, thinking what would happen because of my inaction. Then I threw on a pair of shoes and ran out the door.

       

      When I was on the right block, there was an ambulance speeding down the street, but it was going the wrong way, probably because of confusing signs in that neighborhood. I knew how to navigate it though.

       

      I got there just after a girl who also turned out to be an SMS life saver. She had been in the street, waving at the ambulance when it went by. One other guy had started CPR, but I jumped in and took over. It was only about 20-40 seconds before the ambulance and police approached. Once they took over I just sort of left and went home.

       

      I don't know if he survived, and I don't know if I want to find out. I hope what little I did contributed to saving his life."

      If that experience sounds like a nice rush, there's a tradeoff. Another Swedish Redditor named Fentonquest has a stern warning for any potential Dalecarlians thinking of getting involved: "You will face an already deceased person sometimes. You need to know this before you sign up." Once on the scene, Fentonquest says, the authorities will be worried about the sick person, not your delicate sensibilities: "No one will have the time to ask you how you feel. No one will debrief you."

      Despite potentially traumatized volunteers, the experiment seems to be going really well. According to their formal study, volunteers were on the scene faster than an ambulance 44 percent of the time, and they began CPR 42 percent of the time. The abstract says, however, "The potential survival effect of these findings needs to be thoroughly evaluated in a randomized trial."


      screencap via

      And why don't we have this in the US? It would be easy to scoff and point at a picture of John Boehner, but we might not be so far behind on this one. There's an app called Pulsepoint that works on a similar principle, but its busy interface lacks the laser focus of SMS Life Savers. The app is crowded with information about fires, car crashes, and every other type of emergency in your whole city. However, their melodramatic PSA makes them look like the soul sibling of SMS Life Savers:

      With a clearer mission, Pulsepoint could be a big step toward solving this ambulance problem, but I still don't think they're catchy enough. They really ought to introduce a separate, cardiac-arrest-only app to complement pulsepoint. I would call it "Heart Signal" and it would play The Batman Theme whenever you're called into action, except slightly modified so that it's the Heart-Man-or-Woman Theme. You probably think I'm being glib, but I bet it would save lives.

      @MikeLeePearl

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      Topics: CPR, Sweden, stockholm, heart attacks, cardiac arrest, SMS life savers, Pulsepoint, SMSlivräddare

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