Cell­phone could be a life saver

Ex­per­i­men­tal app might spot over­doses in time to help

The Hazleton Standard-Speaker - - HEALTH / WEATHER - BY LAU­RAN NEER­GAARD AP MED­I­CAL WRITER

WASH­ING­TON — Too of­ten peo­ple die of an opi­oid over­dose be­cause no one’s around to no­tice they’re in trou­ble. Now sci­en­tists are cre­at­ing a smart­phone app that beams sound waves to mea­sure breath­ing — and sum­mon help if it stops.

The app is still ex­per­i­men­tal. But in a novel test, the “Sec­ond Chance” app de­tected early signs of over­dose in the crit­i­cal min­utes af­ter peo­ple in­jected heroin or other il­le­gal drugs, re­searchers re­ported Wednes­day.

One ques­tion is whether most drug users would pull out their phone and switch on an app be­fore shoot­ing up. The Univer­sity of Wash­ing­ton re­search team con­tends it could of­fer a much-needed tool for peo­ple who haven’t yet found ad­dic­tion treat­ment.

“They’re not try­ing to kill them­selves — they’re ad­dicted to these drugs. They have an in­cen­tive to be safe,” said Shyam­nath Gol­lakota, an en­gi­neer­ing and com­puter sci­ence as­so­ciate pro­fes­sor whose lab turns reg­u­lar cell­phones into tem­po­rary sonar de­vices.

But an emer­gency room physi­cian who reg­u­larly cares for over­dose pa­tients won­ders how many peo­ple re­ally would try such a de­vice.

“This is an in­no­va­tive way to at­tack the prob­lem,” said Dr. Zachary Dez­man of the Univer­sity of Mary­land School of Medicine, who wasn’t in­volved in the re­search.

Still, “I don’t know if many folks who use sub­stances are go­ing to have the fore­thought to pre­pare,” he added.

More than 47,000 peo­ple in the U.S. died of opi­oid over­doses in 2017. The drugs sup­press breath­ing but a medicine called nalox­one of­ten can save vic­tims — if it reaches them in time. Usu­ally, that means some­one has to wit­ness the col­lapse. Dr. Ja­cob Sun­shine, a Univer­sity of Wash­ing­ton anes­the­si­ol­o­gist, notes that peo­ple have died with a rel­a­tive in the next room un­aware they were in trou­ble.

The re­search team set­tled on cell­phones as po­ten­tial over­dose mon­i­tors be­cause just about ev­ery­one owns one. They de­signed an app that mea­sures how some­one’s chest rises and falls to see if they’re slip­ping into the slow, shal­low breaths of an over­dose or stop breath­ing com­pletely.

The soft­ware con­verts the phone’s built-in speaker and mi­cro­phone to send out in­audi­ble sound waves and record how they bounce back. An­a­lyz­ing the sig­nals shows spe­cific breath­ing pat­terns.

It won’t work in­side a pocket, and peo­ple would have to stay within 3 feet. The re­searchers are in the process of mak­ing the app ca­pa­ble of di­al­ing for help if a pos­si­ble over­dose is de­tected.

They put the ex­per­i­men­tal gad­get to the test at North Amer­ica’s first su­per­vised in­jec­tion site in Van­cou­ver, British Columbia, where peo­ple are al­lowed to bring in il­le­gal drugs and in­ject them­selves un­der med­i­cal su­per­vi­sion in case of over­dose. Study par­tic­i­pants agreed to have doc­toral stu­dent Ra­jalak­shmi Nan­daku­mar place the app-run­ning cell­phone nearby dur­ing their reg­u­larly mon­i­tored visit.

The soft­ware cor­rectly iden­ti­fied breath­ing prob­lems that could sig­nal an over­dose — seven or fewer breaths a minute, or pauses in breath­ing — 90 per­cent of the time, the re­searchers found. Most were near-misses; two of the 94 study par­tic­i­pants had to be re­sus­ci­tated.

For a big­ger test, the re­searchers next turned to peo­ple who don’t abuse drugs but were about to re­ceive anes­the­sia for elec­tive surgery.

Ren­der­ing some­one un­con­scious for an op­er­a­tion mim­ics how an over­dose shuts down breath­ing.

Mea­sur­ing 30 sec­onds of slowed or ab­sent breath­ing as those pa­tients went un­der, the app cor­rectly pre­dicted 19 of 20 sim­u­lated over­doses, the re­searchers re­ported. The one missed case was a pa­tient breath­ing slightly faster than the app’s cut­off.

The find­ings were re­ported in the jour­nal Sci­ence Trans­la­tional Medicine. The re­searchers have pa­tented the in­ven­tion and plan to seek Food and Drug Ad­min­is­tra­tion ap­proval.

MARK STONE / UNIVER­SITY OF WASH­ING­TON

This im­age from video shows a demon­stra­tion of the smar tphone app de­vel­oped by Ra­jalak­shmi Nan­daku­mar, Shyam­nath Gol­lakota and Ja­cob E. Sun­shine that uses sound waves to mea­sure breath­ing.

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