Each year 40,000 people in Germany have to be resuscitated, but only 15 percent of first aiders have the confidence to perform cpr in an emergency. However, the chance of survival decreases by 5.5 percent for every minute without cpr. Up to 10,000 people per year would have a chance to survive if 12 percent more first aiders performed cpr until the ambulance arrived.
What are the reasons for this? Why do only a few first aiders take life-saving measures? And how can this be changed for the better? Together with a team of medical students and paramedics, I set out to find answers.
In fact, many people don’t know how cpr works. First aiders are also in a situation of extreme stress. They feel helpless and are afraid of doing something wrong. Being overwhelmed and lacking cpr skills leads to people freezing and waiting passively for the ambulance to arrive – even though they really want to help.
Anyone who calls an ambulance already has their smartphone in their hand – and that’s exactly where this project comes in. Code Blue is a voice assistant that supports first aiders step by step in performing cpr, gives them confidence and encourages them.
Voice user interfaces offer a significant advantage: both hands remain free, and people don’t have to look at their smartphone display. Psychological factors also play a crucial role; being addressed directly decreases the bystander effect and pulls first aiders out of their state of shock using explicit instructions.
Code Blue also has a training mode to practise CPR and improve your skills. Even though most people rarely get into an emergency, training and routine responses can save lives.
The voice assistant supports the whole rescue chain – from first aiders to paramedics. Sharing the device location allows to trace the emergency and shortens the time until the ambulance arrives. Code Blue automatically logs every CPR to provide critical information for further medical treatment, e.g. duration or start time.
The idea of guiding first aiders via voice during CPR isn’t entirely new. Some rescue coordination centres in Germany have been testing telephone resuscitation (T-CPR) for emergency calls since 2010 – with remarkable success. The dispatchers follow a medical protocol that was developed primarily for use on the phone. These guidelines structured like an algorithm, form the basis for Code Blue. This way, the voice assistant is able to react to different emergency scenarios and adapt accordingly.
The emergency mode starts a step-by-step conversation. The app asks the first aider a question or gives a short, precise instruction. Code Blue then responds to the first aider’s answer and moves to the appropriate next step. If the voice assistant does not receive feedback, it repeats the step to ensure everything was understands.
In addition to speech, Code Blue communicates on two more levels: text and animation. Offering different ways of communication works as a security backup and helps accessibility. All voice interactions are also displayed as text in large size. So it’s still readable even though you can’t grab your smartphone. Animations complete the instructions and demonstrate how to perform each step. Since some people’s voices slip under stress, all steps can also be carried out manually without voice commands.
Code Blue isn’t limited to smartphones. With smartwatches like the Apple Watch, first aiders are able to receive very precise CPR instructions. Built-in sensors allow Code Blue to measure exactly if the necessary chest compression depth is archived during CPR – a critical factor for survival rate.
Frequent training and routine handling can save lives in case of a medical emergency. Even if you may never have to take life-saving actions, knowing what to do is good. Routine protects our brain from being overwhelmed in stressful situations and helps us recall learned actions more quickly.
Code Blue’s training mode allows you to practise different emergency situations and improve your CPR skills. What is most motivating to train frequently? Progress – we all love to see how we get better with every training. Code Blue evaluates all training sessions and shows people their learnings and achievements.
Voice-assistedcpr is still a pipe dream and will probably remain so for a long time. Technological issues aren’t the only challenges that stop Code Blue from becoming a reality. Lots of legal, ethical and practical questions remain unanswered so far. It would need a diverse team of physicians, lawyers and civil society representatives to explore and resolve these issues. Code Blue is, therefore, only a thought experiment about what would happen if Siri could help us with more than the weather forecast and our calendar.