It is seven years ago since Helena Jäntti, and Sakari Syväoja sat down and started to discuss if it would be possible to recognise lifelessness with the help of a smartphone. This discussion was the beginning of Heart2Save and Syväoja’s doctoral thesis about recognition of out-of–hospital cardiac arrests.
Syväoja and Jäntti have known each other since they studied at the University of Eastern Finland. Syväoja once moved from Helsinki to Kuopio in order to study medicine; later his summer job took him to Joensuu. To Savonia and Kuopio Sakari returned for his specialisation courses in 1991 and years after that to Joroinen for his Emergency Doctor training in a rescue helicopter.
ALIVE OR LIFELESS – THE ASSESSMENT OVER THE PHONE IS DIFFICULT
When a medical emergency occurs outside of the hospital, the emergency number is called. ”The most serious and urgent situation is cardiac arrest. Then you should get help within minutes and start cardiopulmonary resuscitation immediately. This would, however, mean that one would already during the emergency call need to recognise that it is a case of cardiac arrest and lifelessness.” Sakari tells us.
”Nowadays the recognition of cardiac arrest is based on if the person is unresponsive and on the evaluation of the breathing. If an unresponsive person doesn’t breathe or doesn’t breathe normally, the starting point is that he/she is lifeless. The evaluation of if someone is breathing or not is difficult for an expert, not to speak of a layman. Let alone for the emergency service dispatcher who needs to evaluate over the phone,” Sakari explains. ”Many times the emergency service dispatcher must draw between different dispatch codes when there is no clarity in if the patient is lifeless or alive. It is mentally a very stressful situation, and it depends much on the psychological state of the caller, what kind of information the dispatcher gets regarding the incident. If the cardiac arrest is recognised, the cardiopulmonary resuscitation starts earlier and chances for survival increases.”
”To recognise lifelessness during the emergency call is vital.”
Syväoja’s doctoral thesis researched an extensive amount of material (of more than 2000 patients), in order to understand what the recognition of lifelessness means. ”A bigger part of the patients are being discharged from the hospital if lifelessness has been recognised during the emergency call and the cardiopulmonary resuscitation has started in time,” Sakari explains. ”To recognise lifelessness during the emergency call is vital.”
Helena and Sakari started together to think about a new way to approach and solve this recognition problem.