Can untrained laypersons use a defibrillator with dispatcher assistance?
OBJECTIVE
Automated external defibrillators (AEDs) provide an opportunity to improve survival in out-of-hospital cardiac arrest by enabling laypersons not trained in rhythm recognition to deliver lifesaving therapy. This study was performed to examine whether untrained laypersons could safely and effectively use these AEDs with telephone-guided instructions and if this action would compromise the performance of cardiopulmonary resuscitation (CPR) during a simulated ventricular fibrillation out-of-hospital cardiac arrest.


METHODS
Fifty-four conscripts without previous medical education were recruited from the Western Command in Finland. For this study, the participants were divided at random to form teams of two persons. The teams were randomized to dispatcher-assisted CPR with or without AED operation during a simulated ventricular fibrillation out-of-hospital cardiac arrest. The time interval from collapse to first shock, hands-off time, and the quality of CPR were compared between the two groups.


RESULTS
The quality of CPR was poor in both groups. The use of an AED did not increase the hands-off time or the time interval to the first compression. Sixty-four percent of the teams in the AED group managed to give the first defibrillatory shock within 5 minutes.


CONCLUSIONS
The quality of dispatcher-assisted CPR is poor. Dispatcher assistance in defibrillation by a layperson not trained to use an AED seems feasible and does not compromise the performance of CPR.
Harve
Heini
H
Department of Anesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. heini.harve@helsinki.fi
Jokela
Jorma
J
Tissari
Antti
A
Saukko
Ari
A
Räsänen
Petri
P
Okkolin
Toni
T
Pettilä
Ville
V
Silfvast
Tom
T
D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000706:statistics & numerical data*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D017216:Telemedicine; D013689:Telephone