title: Automated external defibrillator program does not impair cardiopulmonary resuscitation initiation in the public access defibrillation trial.
abstract: OBJECTIVE
  To evaluate whether automated external defibrillator (AED) training and AED availability affected the response of volunteer rescuers and performance of cardiopulmonary resuscitation (CPR) in presumed out-of-hospital cardiac arrest (OOH-CA) during the multicenter Public Access Defibrillation Trial.
  
  
  METHODS
  The Public Access Defibrillation Trial recruited 1,260 facilities in 24 North American regional sites to participate in a trial addressing survival from OOH-CA when AED training and availability were added to a volunteer-based emergency response team. Volunteers at each facility were trained to perform either CPR alone (CPR) or CPR in conjunction with AED use (CPR+AED) according to randomized assignments. This study reports the frequency of response and initiation of CPR actions (chest compressions and/or ventilations) by volunteers in the CPR and CPR+AED study groups.
  
  
  RESULTS
  A total of 314 presumed OOH-CA episodes occurred in CPR facilities, and 308 occurred in CPR+AED facilities. The volunteers were matched well for age, gender, and other features. Overall, ventilations (23.1% vs. 13.1%), chest compressions (24.4% vs. 12.1%), and both actions (19.8% vs. 10.5%; all p < 0.05) were more commonly performed in OOH-CA cases in the CPR+AED group. However, when only OOH-CA cases with volunteers responding were analyzed, the rates of CPR actions were similar. In the subgroup of CPR+AED cases with a responding volunteer, the AED was turned on for only 47% of cases. Volunteers initiated a CPR action more commonly when the AED was turned on (60.7% vs. 39.3%; p = 0.003).
  
  
  CONCLUSIONS
  In the Public Access Defibrillation Trial, rates of CPR actions for presumed OOH-CA victims were low but similar for CPR and CPR+AED responding volunteer rescuers. Factors associated with volunteer response, CPR action initiation, and AED activation warrant further investigation.
authors.affiliation: Center for Policy & Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health Sciences University, Portland, OR 97239-3098, USA. hedgesj@ohsu.edu
authors.forename: Jerris R
authors.initials: JR
authors.lastname: Hedges
authors.forename: Ruchir
authors.initials: R
authors.lastname: Sehra
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Van Zile
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Anton
authors.forename: Lois A
authors.initials: LA
authors.lastname: Bosken
authors.forename: Robert E
authors.initials: RE
authors.lastname: O'Connor
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.forename: Judy L
authors.initials: JL
authors.lastname: Powell
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: McBurnie
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000706:statistics & numerical data*; D017028:Caregivers / Q000193:education / Q000706:statistics & numerical data; D016001:Confidence Intervals; D047548:Defibrillators / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000295:instrumentation / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D017150:Public Sector / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D014481:United States / Q000453:epidemiology; D014838:Volunteers / Q000193:education / Q000706:statistics & numerical data*