Having a heart attack? New app will alert nearby CPR givers

EVERETT — The game was almost over when Lowell Zenk set up to battle over a corner kick.

Then his heart stopped. He collapsed to the turf at Kasch Park.

“I was talking to him one minute, and when I looked back, he had just face-planted, and he was not OK,” teammate Julie Plitnik recalled.

Not everybody gets as lucky as Zenk. Few cardiac arrests interrupt 11-on-11 soccer matches, where the odds are good that a witness is trained to try life-saving efforts.

First-responders announced Tuesday that the cellphone app PulsePoint will now alert citizens in Snohomish County that someone nearby, within a quarter-mile of their geolocation, is likely in need of CPR. It should mean better chances of survival for the roughly four to five people who suffer a cardiac arrest each day in the county.

Plitnik and another player, Jenny Garcia, took charge on the evening of May 5, 2019, trading off chest compressions until paramedics arrived. According to the Everett Fire Department, they saved a man’s life.

The hope is that PulsePoint will create more survival stories like Zenk’s. The app is tied into the county’s 911 dispatch center. It had a “soft-launch” for local first-responders in August to work out kinks before it went public.

Now anyone in Snohomish County can sign up for free by downloading PulsePoint to a smartphone, via the App Store or Google Play.

PulsePoint has other valuable features, too.

In a companion app, there’s a crowd-sourced map of Automated External Defibrillators, better known as AEDs — creating a registry that even 911 dispatchers did not have until now.

“As the AED registry grows and our software is updated, dispatchers will actually get more visibility and be able to tell a caller who might be new to the building, ‘There’s an AED on the wall behind you,’” said Kurt Mills, executive director of Snohomish County 911. “That’s pretty amazing.”

PulsePoint also creates an automated map of active emergency incidents: car crashes, downed power lines, water rescues, floods, fires and other responses in the public interest. It’s routed through the dispatch center, so these are confirmed reports to 911, rather than fourth-hand hearsay from the Facebook rumor mill.

Around the country, PulsePoint hosts 2.3 million users, with 400,000 “citizen first-responders” who have been called to 115,000 cardiac emergencies, according to the nonprofit that runs the app.

“Enabling Citizen Superheroes,” is the tagline on PulsePoint’s website — and that’s the biggest selling point.

One-fifth of cardiac arrests occur in public, not counting incidents in hospitals, according to the American Heart Association. In Snohomish County, that figure was roughly 17% last year.

Citizen CPR can double or triple the chances of a patient pulling through.

Everett Assistant Fire Chief Rich Llewellyn worked in Spokane Valley when his fire department became one of the first to roll out the app in 2014. In a district of 125,000 residents, volunteer rescuers gave CPR about five or six times per year because of the app, Llewellyn said. Snohomish County’s population is six times bigger.

“I think it’s fairly likely,” Llewellyn said, “that a life will be saved here before the end of the year.”

‘Coming back’

Soccer has been a lifelong love for Zenk. He learned the game at age 5 and coached high school kids for about 15 years. Now 55, he played for a co-ed team called the Inferno in the Snohomish County Adult Soccer Association, on Sunday evenings at Kasch Park in Everett. It’s a rec league for those over 30 — a fun way to meet people and get a much-needed mental break from work.

Zenk’s company, run with his wife in Granite Falls, distributes many of the plump shiitake and oyster mushrooms at Uwajimaya, the Sno-Isle Food Co-op and elsewhere. After 20 years of being self-employed, he joked, the stress finally caught up to him in 2019.

Earlier in the year, Zenk had asked one of his teammates, Plitnik, if she knew CPR, and if she felt good about using it. She told him she felt comfortable with it, given her background as a pre-med student, a skier and a soccer coach herself. It was a question that seemed to come out of nowhere, Plitnik recalled. Zenk did not mention his father had a triple bypass a decade earlier, that his brother died following a heart attack in 2018, or that he had been scheduling a checkup with a cardiologist due to his family history. He just told Plitnik it made him feel safer to have her there.

On Cinco de Mayo 2019, the game was getting “kind of froggy,” recalled Plitnik, who has played soccer for years on Zenk’s team.

“Some people,” Plitnik said, “don’t like getting beat by old slow people.”

The game started at 6:30 p.m., like it does every Sunday. Zenk can’t recall much from that night. He can’t remember the exact score, except that his team was on the sad side of a blowout. Later, there was a running joke: “Well, we were coming back,” Plitnik said. “Yeah, we were coming back — in an ambulance.”

About 90 minutes after the first whistle, Zenk collapsed. It took a moment for everyone to recognize it was a real emergency. Then everything became deadly serious. Plitnik couldn’t tell if Zenk was having a stroke, a heart attack — or what. His jaw locked up. Garcia, who played on the opposing team, couldn’t move his chin. Plitnik wasn’t so polite. She wrenched his jaw open. Somebody tried to explain to her that they didn’t need to do mouth-to-mouth, and Plitnik thought, “Well, yeah, you’re not the one down here doing it, so …” His pulse stopped. He went gray. People got on their knees to pray.

“Lowell doesn’t remember this,” Plitnik said, “but we essentially saw him die, because his color left.”

If Zenk collapsed today, PulsePoint would have beeped out an ear-catching red alert sound within moments of the 911 call on phones around Kasch Park.

The alert is almost instant. It doesn’t add even a split-second of work for the dispatcher. Testing showed it took about 10 seconds to push out an alert in Snohomish County, once it had been entered into the system, said the dispatch center’s director of operations, Andie Burton.

Meanwhile, ambulances can only drive so fast.

On average, it took Everett paramedics a little over six minutes to reach the scene of an aid call in 2020, according to the department’s annual report. That’s based on roughly 15,000 requests for service.

“We don’t have a firefighter in every corner,” Llewellyn said.

Add up all the time it took for somebody to recognize Zenk wasn’t playing some kind of practical joke, the time for someone to actually dial 911, for a dispatcher to tone out an ambulance, for paramedics to find the right soccer game in the park, to get the wires of the AED onto Zenk’s chest — and it becomes clear not everything is captured in the dispatch record, saying it took about eight minutes for the first Everett Fire Department truck to arrive at the scene. Ask Plitnik today, and she remembers it felt like 15 minutes, maybe 20, before she saw paramedics.

Try as they might, Plitnik and Garcia could not revive Zenk by themselves.

Paramedics found them on the soccer field. They stepped in to relieve the two women, then shocked the patient several times with the defibrillator. Zenk woke up, alert and talking. He felt OK, really, though his chest was sore. (Cracked ribs.) He knew exactly where he was, “Field No. 1,” to the confusion of paramedics who were hoping to hear, “Kasch Park.”

At first, Zenk protested against going to the hospital. He was overruled. He spent a week at Providence Regional Medical Center Everett. He credited his surgeon, Dr. Zach DeBoard, not only for his work on the operating table but for explaining procedures to him clearly. Zenk was released after a quadruple bypass and an “extra heavy-duty sew job.”

“I’ve got a lot of steel in my chest,” he said.

Right after he landed in the hospital, he got a phone call about that appointment he’d been trying to set up with a cardiologist. They were ready to see him now.

‘Your chance’

Reality is that cardiac arrest survival rates are bleaker than most people think, with about 10% of patients ever getting released to go home.

The odds of surviving without CPR decreases by as much as 10% with every minute that passes within view of witnesses, according to a series of studies in the 1990s. With CPR, it’s a more gradual decrease of about 3% to 4% per minute.

Looking at local figures from last year, Marysville Fire District spokeperson Christie Veley said, “If you did not get bystander CPR, and your cardiac arrest was not witnessed by someone, then your chance of survival is slim to none.”

Citizen CPR gives a patient a fighting chance, she said.

In 2020, records show the cardiac arrest survival rate was 12.7% in Snohomish County. For patients who had some bystander intervention, the rate rose all the way to 52.1%, Veley said.

“That statistic really points to the essence of why we think this app is important,” she said. “… The more we can get people to act in cases where it can make a difference, that’s going to lead to better outcomes.”

Studies have shown citizen CPR, followed by a defibrillator shock within 5 minutes, can boost survival rates to 50% or even 75%.

An AED delivers a shock to the heart when it detects a heart rhythm that is “incompatible with survival,” Llewellyn said. If a PulsePoint user finds an AED in public, that person can check to see if it’s uploaded into the app. If not, the user can take a picture and send it to the local fire department for approval. Once in the system, Llewellyn said, it can change the conversation in a life-or-death 911 call.

It’s no longer a question: “Do you know if there’s an AED nearby?”

Instead, the dispatcher can say, “There’s an AED near the front entrance of the building you’re in.”

Only cardiac arrests in public places generate a PulsePoint alert for the public. The app automatically strips any information that could identify a patient. Some communities have activated a verified responder program, whereby approved first-responders get alerts in a wider radius — a half-mile, for example — and at private homes within their jurisdiction. As of this month, fire departments had not activated a verified responder program in Snohomish County, but the hope is it will roll out soon.

Other 911 centers in the region have been plugged into the app for years. The Seattle Fire Department became the first agency to launch it in King County 2016. Over 6,700 people signed up within PulsePoint’s first three years in Whatcom County, with many of those joining amid a promotional campaign with posters, bus placards and movie theater ads.

The app’s launch in Snohomish County will be funded by a $35,000 grant from the Medic One Foundation based in King County. If the grant isn’t renewed in a year, local fire agencies would split the cost for funding.

Seventeen fire districts in Snohomish County had enabled a public feed and map of 911 incidents — all but District 5 (Sultan) and District 25 (Oso). Map settings can be customized by each department, and medical calls at private homes won’t be posted by the Marysville Fire District, for example. The Tulalip Bay Fire Department only planned to activate that piece of the app for verified responders, once that part of the program is ready to go.

A built-in emergency radio scanner will not launch right away with the app in Snohomish County, either. Other unofficial scanner apps such as Broadcastify are available for free, for those without a good old fashioned police scanner.

Zenk said it took him a moment to grasp what the app’s about, but once he understood it, he was eager to help promote it.

Two years after a brush with death, Zenk said, he feels he has more endurance than he did before. You can still find him on the soccer field almost every weekend. His first game back in the league, he played Garcia’s team again. It was the most polite game of soccer you’ve ever seen, Plitnik said. Everyone wanted to give everyone else a chance at a goal.

“Who wants the ball?” she recalled people saying. “Do you want the ball?”

On Tuesday, a row of fire chiefs from around Snohomish County unveiled the app at a news conference at Kasch Park. In the distance you could hear intermittent thuds of soccer balls being kicked.

Plitnik spoke. What happened didn’t just change the course of Zenk’s life, but others’, too, she said.

“We used to just play 90 minutes together once a week,” she said. “It became bigger. It became about your neighbor, about a life, about a community member, and then it became about a mother not losing her son, a brother getting more time, a wife not being a widow, two sons — barely adults themselves — not having to face the world without a dad. … We were lucky.”

Caleb Hutton: 425-339-3454; chutton@heraldnet.com. Twitter: @snocaleb.

Get the app!

To find out more about PulsePoint, and how to download the app, visit pulsepoint.com. It’s available in English, Spanish, (Canadian) French and Japanese.

Learn CPR!

To get CPR training, contact your local fire department. South County Fire, for example, has free one-hour classes that teach basic first aid, but you must register in advance.