UF simulation experts develop new CPR app to help emergency responders keep the beat

By Melanie Stawicki Azam

Stan’s heart rate stops and his breathing halts as a flat line glows on the computer monitor beside the bed.

Teenager Scott Rice hurries to do chest compressions that are deep enough and positioned right, but he struggles to time his compressions at the proper rate of 100 per minute. When he adds in ventilation, which involves giving a breath eight to 10 times a minute, things get more confusing.

Thankfully, Stan is a human patient simulator in the University of Florida College of Medicine’s Center for Safety, Simulation and Advanced Learning Technologies.

“What if that’s me and you need your tuition paid for?” jokes his father Mark J. Rice, M.D., an anesthesiologist at the college.

Simulation lab engineer Isaac Luria intervenes at just the right moment and turns on the CPR application he created with Nikolaus Gravenstein, M.D., the Jerome H. Modell, MD professor of anesthesiology at UF.

“Listen to the beat,” Luria tells Scott Rice. “We have audio clues for you.”

A regular beep cues the teen, giving him a rhythm to follow for the chest compressions. Meanwhile, a second audio cue, which has a different pitch, tells him when to give Stan a breath. Using the two sounds, Rice gets into a routine and the “patient” begins to revive.

“That’s pretty awesome,” Scott Rice said.

But the app, which can be downloaded onto Motorola’s Droid smartphone, does more than that. It also indicates elapsed time since the administration of when emergency responders should administer four different medications —epinephrine, vasopressin, amiodarone, and lidocaine — and the most recent defibrillation.

“It’s so simple, but it addresses a very common need,” said Gravenstein, who asked Luria to develop the app. “The idea that you have multiple stop watches running simultaneously is unique.”

The app is intended for use by emergency responders and health care professionals, as opposed to students, Luria said. During a real-life emergency or trauma, it’s easy to lose track of time and difficult to correctly time multiple tasks simultaneously. The CPR app is a tool that helps emergency responders perform each task at the right pace and interval for the best patient outcomes.

“This process can go for 30 to 45 minutes, so keeping track of all these things … you can easily lose track of how long it’s been,” he said.

And tThe rate of chest compressions and breaths during CPR is important. Proper compression rates are key to restoring blood flow to the brain and vital organs. Ventilation is often given too rapidly, which isn’t good for the patient’s brain. The medications shouldn’t be given too frequently or infrequently either.

The next step is to have the CPR app tested by clinicians at UF, as well as local emergency responders.

“With a smartphone, we are walking around with a computer in our pocket,” said Gravenstein. “In the heat of the moment, what we hope for is organized, but frequently feels chaotic. This helps provide a little comfort and calm.”

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