The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial.
BACKGROUND
The time to skill deterioration between primary training/retraining and further retraining in cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) for lay-persons is unclear. The Public Access Defibrillation (PAD) trial was a multi-center randomized controlled trial evaluating survival after CPR-only versus CPR+AED delivered by onsite non-medical volunteer responders in out-of-hospital cardiac arrest.


OBJECTIVE
This sub-study evaluated the relationship of time between primary training/retraining and further retraining on volunteer performance during pretest AED and CPR skill evaluation.


METHODS
Volunteers at 1260 facilities in 24 North American regions underwent training/retraining according to facility randomization, which included an initial session and a refresher session at approximately 6 months. Before the next retraining, a CPR and AED skill test was completed for 2729 volunteers. Primary outcome for the study was assessment of global competence of CPR or AED performance (adequate versus not adequate) using chi(2)-test for trends by time interval (3, 6, 9, and 12 months). Confirmatory (GEE) logistic regression analysis, adjusted for site and potential confounders was done.


RESULTS
The proportion of volunteers judged to be competent did not diminish by interval (3, 6, 9, and 12 months) for either CPR or AED skills. After adjusting for site and potential confounders, longer intervals to further retraining was associated with a slightly lower likelihood of performing adequate CPR but not with AED scores.


CONCLUSIONS
After primary training/retraining, the CPR skills of targeted lay responders deteriorate nominally but 80% remain competent up to 1 year. AED skills do not deteriorate significantly and 90% of volunteers remain competent up to 1 year.
Christenson
Jim
J
Department of Emergency Medicine, St. Paul's Hospital, University of British Columbia, 1081 Burrard St., Vancouver, BC, Canada V6Z 1Y6. jimchris@interchange.ubc.ca
Nafziger
Sarah
S
Compton
Scott
S
Vijayaraghavan
Kris
K
Slater
Brian
B
Ledingham
Robert
R
Powell
Judy
J
McBurnie
Mary Ann
MA
D000328:Adult; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002983:Clinical Competence; D047548:Defibrillators; D004521:Educational Measurement; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D013997:Time Factors; D014838:Volunteers / Q000193:education