Kelly Geoffrey S, Clare Drew
Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
J Am Coll Emerg Physicians Open. 2020 Jul 2;1(4):618-623. doi: 10.1002/emp2.12146. eCollection 2020 Aug.
Timely out-of-hospital notifications in patients with traumatic cardiac arrest are associated improvements in mortality. Details surrounding these events are often limited, and decisions to perform advanced resuscitative procedures must be made based on limited data. This study evaluated the ability of a mobile application (app) called Citizen (sp0n Inc., New York, NY) to address these issues by providing a novel, secondary source of out-of-hospital information in traumatic cardiac arrest. Citizen sends notifications to mobile devices in response to nearby detected public safety events, and we sought to evaluate its utility in prenotification for traumatic cardiac arrest.
This was a retrospective observational study. Patients ≥ 15 years of age with traumatic cardiac arrest attributed to penetrating trauma were included. The 2 coprimary outcomes observed were the time difference between the app notification and emergency medical services notification, and the app's success rate in generating a notification for each patient in traumatic cardiac arrest.
From February 2, 2019 to October 10, 2019, there were 43 patients who met the criteria for this study. On average, the Citizen app notification arrived 12.9 minutes before emergency medical services radio notification (95% confidence interval, 9.2-16.6; < 0.001). Citizen generated a notification for 36 of 43 patients (84%).
The Citizen app generates earlier notifications in traumatic cardiac arrest compared with standard radio communications. It also provides a previously unavailable secondary source of information for making rapid resuscitative decisions upon the arrival of the arresting patient to the emergency department. Further research is needed to determine how to optimally integrate the app into existing trauma systems.
创伤性心脏骤停患者的院外及时通知与死亡率的改善相关。这些事件的详细情况通常有限，必须基于有限的数据做出进行高级复苏程序的决定。本研究评估了一款名为Citizen（纽约州纽约市sp0n公司）的移动应用程序（应用）通过提供创伤性心脏骤停院外信息的新的二级来源来解决这些问题的能力。Citizen会响应附近检测到的公共安全事件向移动设备发送通知，我们试图评估其在创伤性心脏骤停预通知方面的效用。
这是一项回顾性观察研究。纳入了年龄≥15岁、因穿透性创伤导致创伤性心脏骤停的患者。观察的两个共同主要结局是应用通知与紧急医疗服务通知之间的时间差，以及应用针对每位创伤性心脏骤停患者生成通知的成功率。
从2019年2月2日至2019年10月10日，有43名患者符合本研究标准。平均而言，Citizen应用通知比紧急医疗服务无线电通知提前12.9分钟到达（95%置信区间，9.2 - 16.6；P < 0.001）。Citizen为43名患者中的36名（84%）生成了通知。
与标准无线电通信相比，Citizen应用在创伤性心脏骤停中能更早发出通知。它还为在心脏骤停患者到达急诊科时做出快速复苏决定提供了以前无法获得的二级信息来源。需要进一步研究以确定如何将该应用最佳地整合到现有的创伤系统中。
