A Positive Shock To The System

You know that out-of-hospital cardiac arrests (OHCAs) have the potential to be lethal. You might even know someone who’s had one. Even more than other medical emergencies, surviving an OHCA relies on getting the right help to the right place at the right time.

You know that using the Medical Priority Dispatch System^™ (MPDS^®) Breathing Verification Diagnostic Tool can help you determine whether a patient’s breathing is really agonal respirations. Getting hands on chest is crucial in keeping the blood flowing through the patient’s heart and brain to give them a better shot at survival. Many of you may have even taken an OHCA call and can’t possibly explain to others how it feels to calm the patient’s loved ones enough to get them to follow your CPR instructions.

AEDs are invaluable in cases of sudden cardiac arrest (SCA). An SCA is caused by the “sudden interruption to the heart’s electrical activity,” which results in the heart beating abnormally. If the abnormality isn’t corrected by the AED’s shock, the patient “will most likely die or suffer severe neurological damage.”

You may be aware of the movement by organizations such as the American Heart Association (AHA) and the Centers for Disease Control and Prevention (CDC) to put AEDs in public places such as workplaces, gyms, and schools in order to have that resource available. Remember, Brock’s Law states that “The presence of an AED does not ensure its use; an EMD does.”

Do you know how often an AED is actually used in cases of OHCA? A study published in 2019 found that out of 18,904 cases for which the AED prompt was displayed in the MPDS, an AED was reported as available only 5.8% of the time, and 72% of the time it was available, rescuers who were sent to get an AED were unable to retrieve it.¹

Avive Solutions Inc.’s 4 Minute Community (4MC) Program is aware of that gap in the chain of survival and has a plan to bridge it.

CARE Teams
Avive Solutions was founded in 2017 on the principle “that anyone can and should be able to positively impact the outcome of a Sudden Cardiac Arrest (SCA) rescue.” The company’s goal is to increase the survival rate for SCA by “proactively empowering people with reliable life-saving tools.”² One of those tools is the Connect AED, which automatically notifies 911 communication centers within a predetermined radius when it’s activated. These smart AEDs share a wealth of information with the emergency dispatcher: the location of the emergency, the time since activation, heart rhythm analysis, the state of pad placement, and the number of shocks delivered.

But the communication doesn’t just go one way—if someone calls 911 and reports an OHCA, 911 centers connected to this network can send an alert to Avive Connect AEDs that are within one mile of the location of the medical emergency. The Avive Connect AEDs—which belong to trained volunteers—emit an audible alert and display the exact location of the patient, along with how long it will take to walk or drive there.

“It gives dispatchers access to data and information that they’ve never had before,” said Julie Buckingham, Senior Manager of Community Programs at Avive. “CPR instructions stall the dying process, but AEDs can stop it. Being part of the CARE Team is giving dispatchers access to another powerful tool in the chain of survival.”

It also closes the gap between OHCA and response arrival. According to the 2024 Cardiac Arrest Registry to Enhance Survival (CARES) annual report, 15% of OHCAs occurred in a public location.³ But, Buckingham asks, what happens when the arrest occurs in a private residence, where 71.3% of arrests take place? In these residential settings, the use of AEDs by lay rescuers is so rare it’s nearly immeasurable.

Implementing the 4 Minute Community Program is, as the name implies, truly a community effort. Members in a potential 4MC will put together a leadership team, which is usually comprised of local officials such as the mayor’s office; the chamber of commerce; the police, fire, and EMS departments; and, of course, emergency dispatch.

The Avive Connect AED received approval as a medical device from the FDA in 2022, and by July 2023, the first three 4MC and CARE Teams went live in Cumberland County (Pennsylvania, USA), Forsyth County (Georgia, USA), and Jackson (Tennessee, USA).

Cumberland County Department of Public Safety
Providing aid to 270,000 residents over 550 square miles, the Cumberland County Department of Public Safety in Pennsylvania dispatches for 17 municipal police departments, 10 EMS companies, and 36 fire departments. There are 46 full-time and 12 part-time Emergency Dispatchers to handle the roughly 90,000 emergency and 250,000 nonemergency calls that come in annually. Its size and staffing has doubled since both Bob Shively, Director of Public Safety, and Mike Snyder, Deputy Director – 911, began working there in the early 1990s.

“When I started, we didn’t even have protocols,” Shively said. “And when protocols did come out, everyone was a little leery. But once they saw them in action, the dispatchers changed their minds. The 4MC Program is the biggest industry game-changer since we implemented protocols 30 years ago.”

Working with Avive and RapidSOS, Cumberland County gathered community partners such as the hospital and the county commissioner’s office and explained the chain of survival and how the 4MC Program would better connect all of those links. The groups that came together had open minds, and once Shively and Snyder laid out the why and the how of the program, there was a lot of buy-in.

The CARE Team worked to activate the 300 Avive Connect AEDs to make sure the Emergency Dispatchers had the capability to not only locate devices but also see when the volunteers were responding and when the pads were pulled from the devices to administer shocks.

“It helps us provide more tailored CPR instructions,” Snyder said. “The dispatcher can see if the pads have been pulled. But if it’s been 60 seconds and the shocks haven’t been administered, they can ask the caller what’s going on and see if they need help.”

It didn’t take long before they started to see near-saves and, six months later, their first save.

“Before that, we had alerted folks through the AEDs, but they had not successfully shocked a patient,” Snyder said. “We knew it was a matter of time. Our agencies are already sending maximal responses. This is an opportunity to use community response among neighbors. If we can get a shock there three or four minutes before responders, that gives a 30% higher chance of survival.”

Lyall Lehman was going on his daily run when he collapsed on a footbridge and became unresponsive. When a passerby called 911, Cumberland County Call Taker Daniel Bretzman, EMS Dispatcher Joseph Hruniuk, Police Dispatcher Riley Sanderson, and Fire Dispatcher Andrew Mellott snapped into action. At 4:38 p.m., CARE Team Member Alan Wirt got an alert from his Avive Connect AED, telling him that there was an incident nearby. At 4:40 p.m., Wirt was at Lehman’s side administering the first shock.⁴

After being discharged from the hospital, Lehman appeared at a ceremony to meet those who helped save his life, including Bretzman, Hruniuk, Sanderson, and Mellott.

“It’s not a concept anymore; it’s a proven system now,” Snyder said. “And it’s one of the most impactful things we can do.”

Forsyth County 911 Center
North of Atlanta, Georgia, Forsyth County 911 Deputy Director Rebecca Camantigue, CMCP, has been in this profession almost 30 years. She was raised around public safety—her dad was in law enforcement—so it seemed like a natural choice to go into 911.

Forsyth County 911 dispatches for the sheriff’s office, the city police department, the fire department, and the contracted EMS agency to cover the county’s population of about 258,000 people. There are 12 positions in the radio and calltaking room, and there are at least eight people on the floor at all times to manage the call volume of anywhere from 1,000 to 1,200 calls every day.

Camantigue was involved with the implementation of the 4MC and the CARE Team from the beginning. She got a phone call one day from Sameer Jafri, co-founder and CEO at Avive Solutions, to explain what Avive was and asked if some representatives could come see if Forsyth County 911 was a good fit. The visit went well, and soon the community was working on putting it into practice.

“As soon as we implemented [4MC] in the dispatch center, everyone absolutely loved it,” Camantigue recalled. “It definitely speeds up response times on cardiac arrest calls. Everyone gets involved in watching the AEDs that are nearby when a call comes in, and they’re cheering the volunteers on to get their AEDs and go to the scene.”

While some might worry that this program just adds another thing on top of the towering pile of things an Emergency Dispatcher has to think about during every single call, Camantigue says that the Forsyth County 911 Emergency Dispatchers have gotten really comfortable using it. It’s on their RapidSOS mapping system, so it’s always open and ready for the button to be pressed as soon as the Emergency Dispatcher knows they’re taking a CPR call.

On Thursday, July 24, 2025—about two years, 300 AEDs, and dozens of trained CARE Team members later after 4MC was first implemented—Forsyth County 911 had their first save.

A woman called 911 reporting that her 61-year-old husband had passed out in the yard and was unresponsive. At 7:44 p.m., Public Safety Telecommunicator (PST) Senior Emily Straight, who’s been working with Forsyth County 911 about two years, activated the AED alert. The alert was accepted by a CARE Team member at 7:46 p.m., and the AED was activated on the patient only four minutes later.

“We’re so excited to be able to meet the patient when he gets out of the hospital!” Camantigue said.

When asked what advice she would give other directors and agencies thinking of joining this program, she said, “Don’t be afraid to try to do this program. It’s going to help save a life.”

Get involved
The goal of the 4MC Program and CARE Teams isn’t necessarily the OHCA patient being discharged from the hospital with a clean bill of health, although those instances are certainly celebrated. The goal is to get an AED to the patient as quickly as possible and for that AED to be used by someone who has been trained to do so.

“We’ve had situations where a patient is revived in the field by an AED, but then they die in the hospital,” Buckingham said. “In those instances, we’re not saving the patient. We’re saving the family. We’re giving them time to say goodbye.”

Is your community a good candidate for the 4MC Program? Check out Avive’s website and learn more today: https://www.avive.life/4-minute-community

Sources
1. Gardett I., Broadbent M., Scott G., Olola C., Clawson J.J. “Availability and Use of an Automated External Defibrillator at Emergency Medical Dispatch.” Prehospital Emergency Care. 2019; Feb. 1. https://pubmed.ncbi.nlm.nih.gov/30572769/ (accessed June 30, 2025).

2. “About us.” Avive. https://www.avive.life/about (accessed June 30, 2025).

3. “2024 Annual Report.” Cardiac Arrest Registry to Enhance Survival. 2024. https://mycares.net/sitepages/uploads/2025/2024_flipbook/index.html?page=1 (accessed June 30, 2025).

4. Avive Solutions. “Community member saves a life through Avive’s 4 Minute Community^™ Program in Cumberland County.” YouTube. 2025; Feb. 19. https://www.youtube.com/watch?v=zZXgVMV88Bk&ab_channel=AviveSolutions (accessed June 30, 2025).