A comparison of first-responder automated external defibrillator (AED) application rates and characteristics of AED training.
OBJECTIVE
To determine whether there were associations between the characteristics of first-responder automated external defibrillator (AED) training and AED application rates.


METHODS
This multicenter retrospective cohort study analyzed data from ten emergency medical services systems where first responders were trained and equipped with AEDs. Data were provided for all out-of-hospital cardiac arrests (OHCAs) occurring over two years, including whether the first-responder AED was applied (pads attached to patient). Systems were surveyed to determine the characteristics of their initial and continuing AED training. Data were analyzed using odds ratios (ORs) with 95% confidence intervals (95% CIs).


RESULTS
Overall, the first-responder AED was applied to 53% of 2,181 OHCAs. First responders applied AEDs to 60% of OHCAs when a national AED training curriculum was used and to 49% of OHCAs when a locally created curriculum was used (OR=1.58; 95% CI=1.32-1.88). First responders applied AEDs to 61% of OHCAs when they were trained to the level of Certified First Responder or higher and to 28% of OHCAs when they were trained only in cardiopulmonary resuscitation (OR=3.97; 95% CI=3.20-4.93). First responders applied AEDs to 66% of OHCAs when they each had an opportunity to apply the AED during continuing training and to 17% of OHCAs when they did not have this opportunity (OR=9.04; 95% CI=7.15-11.42). First responders applied AEDs to 59% of OHCAs when they had not received continuing training within one year of their initial training and to 42% of OHCAs when they had received continuing training in the first year (OR=2.00; 95% CI=1.67-2.40).


CONCLUSIONS
Use of a national AED training curriculum, training to the level of Certified First Responder or higher, and the ability for each first responder to apply the AED during continuing training were associated with higher AED application rates. Continuing training within the first year did not appear to be as important as actually using the AED during the training.
Department of Emergency Medicine, Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, 601.Elmwood Avenue, Box 655, Rochester, NY 14642, USA. brooke_lerner@urms.rochester.edu
E Brooke
EB
Lerner
Anthony J
AJ
Billittier
Manish N
MN
Shah
Mary M
MM
Newman
William J
WJ
Groh
D022561:Advanced Cardiac Life Support / Q000193:education* / Q000706:statistics & numerical data*; D001331:Automation; D002568:Certification; D015331:Cohort Studies; D016001:Confidence Intervals; D004496:Education, Continuing; D004554:Electric Countershock / Q000379:methods / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005392:First Aid / Q000379:methods; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011336:Probability; D011361:Professional Competence; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome