title: The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, St. Paul's Hospital, University of British Columbia, 1081 Burrard St., Vancouver, BC, Canada V6Z 1Y6. jimchris@interchange.ubc.ca
authors.forename: Jim
authors.initials: J
authors.lastname: Christenson
authors.forename: Sarah
authors.initials: S
authors.lastname: Nafziger
authors.forename: Scott
authors.initials: S
authors.lastname: Compton
authors.forename: Kris
authors.initials: K
authors.lastname: Vijayaraghavan
authors.forename: Brian
authors.initials: B
authors.lastname: Slater
authors.forename: Robert
authors.initials: R
authors.lastname: Ledingham
authors.forename: Judy
authors.initials: J
authors.lastname: Powell
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: McBurnie
mesh_terms: 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