Automated external defibrillator program does not impair cardiopulmonary resuscitation initiation in the public access defibrillation trial.
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.
Hedges
Jerris R
JR
Center for Policy & Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health Sciences University, Portland, OR 97239-3098, USA. hedgesj@ohsu.edu
Sehra
Ruchir
R
Van Zile
Jonathan W
JW
Anton
Andrew R
AR
Bosken
Lois A
LA
O'Connor
Robert E
RE
Moore
Richard
R
Powell
Judy L
JL
McBurnie
Mary Ann
MA
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*