In 1878, Surgeon-Major Peter Shepherd and Colonel Francis Duncan began the practice of teaching civilians first aid skills. Starting in Woolwich, an area of south east London that was notorious for industrial accidents, proved wise. Within months there were two major disasters: a construction accident involving 160 men and the sinking of a pleasure boat, which resulted in the loss of 600 lives. Newspapers reported that, in the immediate aftermath of both incidents, the prompt assistance of first aiders prevented further death and misery.
The practice of first aid scaled quickly, but significant improvements in our living and working conditions mean that today’s first aiders are less likely than their 19th century counterparts to come across situations where they can help. Many will never use the skills they have gained, a tragic waste of a life-saving resource. This is about to change.
Smartphone technology now enables us to quickly locate trained first aiders and dispatch them to nearby medical emergencies. There are already apps that do this, such as Pulsepoint, which was developed in America and Good Sam, which was developed by a London-based neurosurgeon. Both are gaining traction in countries such as the USA, Australia and South Africa. They are helping to save lives.
However, for this technology to reach its full potential, it needs to integrate into the systems of our emergency services so that first aiders are dispatched in much the same way ambulances are. In 2015, we will see the first ambulance trusts in the UK begin to do this.
It will mean that, when a 999 call is received and it is deemed safe and appropriate, the ambulance service’s dispatch system will automatically locate first aiders in the surrounding area, alert them and ask if they can respond. Responders will range from members of the public with verifiable first-aid training, through to police officers, fire officers and paramedics who might use the app when they are off duty.
This technology will be particularly effective for cardiac arrests. Each year there are over 10,000 out-of-hospital cardiac arrests in the capital. Over 4,000 of these cases could benefit from the presence of a first aider; for every minute that passes without CPR and defibrillation, the chances of survival decrease by 10 per cent.
It doesn’t take much to envisage the impact of this technology. Imagine there is a cardiac arrest in a public place 200 metres from you. The emergency services send you an alert via an app, giving you the location of the incident and asking you to respond. You accept and quickly make your way there using a route given to you by the app, which enables you to pick up a public access defibrillator on the way. How long would this take? Three minutes, maybe four? That’s half the time it would take an ambulance to get there, and patients who receive CPR before the ambulance arrives are almost twice as likely to survive.
In 2015, I predict that the use of this kind of technology by our emergency services will provide the biggest innovation in first aid since it was introduced and lives will be saved as a direct result.
 The Earliest Days of First Aid, John Pearn, BMJ 1994;309:1718