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Investigating the life-saving potential of phone-sized defibrillator

Around 1,700 New Zealanders die from out-of-hospital cardiac arrest each year. Early defibrillation, a shock delivered to the heart, has been shown to improve survival. The FIRST trial investigates whether a new portable defibrillator accessible to community responders can improve survival.

Cardiac arrests can happen anywhere, and the biggest challenge to survival is accessing a defibrillator. Every minute without CPR and defibrillation decreases a person's chances of survival by 10%, making early defibrillation a critical factor in saving lives.

The Heart Foundation is funding Dr Verity Todd, Senior Lecturer with the Department of Paramedicine at Auckland University of Technology, to contribute to research led by Hato Hone St John and Ambulance Victoria exploring whether community responders can effectively employ the CellAED®, an ultra-portable defibrillator, to save lives in real-world settings.

"Early defibrillation significantly improves survival," says Verity. "What we want to see is these devices being available and used by more people in the community. The impact they could make is huge, especially as anyone can use them – we want to see neighbours saving each other's lives."

"The CellAED® is single use, so every time it gets used, we need to replace it," says FIRST Principal Investigator Associate Professor Bridget Dicker, Head of Clinical Audit and Research at Hato Hone St John. "We're providing registered community first responders with the devices and they're alerted through the emergency ambulance services when a cardiac arrest is happening nearby. The important thing is that you don't need to be an expert to use one."

This research is part of a multi-site study called the First Responder Shock Trial (FIRST) and aims to measure the potential of this innovative technology to improve cardiac emergency outcomes across New Zealand. The trial started in November 2022, and the last patient is expected to be enrolled in November 2024; there are currently over 1,700 GoodSAM responders involved in the trial across Australia and New Zealand.

Around 10,000 people are registered as GoodSAM responders in New Zealand. GoodSAM is short for Good Smartphone-Activated Medics. GoodSAMs are volunteers confident in the use of community defibrillators and the performance of CPR who are alerted to a cardiac arrest on their smart phone to help at the scene until an ambulance arrives.

Heart Foundation Medical Director Dr Gerry Devlin says this project addresses the pressing need for better access to defibrillation in communities.

"There are high rates of heart disease in New Zealand and lots of progress has been made to get many defibrillators into publicly accessible locations. However, in some areas where cardiac arrests occur they aren't accessible 24/7, or located in the right places, and more can be done to increase availability in rural communities," he says.

"The funds we are investing will support Verity's role as co-investigator on the FIRST team to explore this innovative solution and evaluate its practicality in our communities."

"I am hugely grateful to the Heart Foundation for funding this vital research," says Verity. "I also want to thank the GoodSAMs – who selflessly give their time and courage to help safeguard the community and are out there right now saving lives."

With a focus on community-based defibrillation, the FIRST trial has the potential to reshape how New Zealanders respond to cardiac emergencies.