title: Improper defibrillator pad usage by emergency medical care providers for children: an opportunity for reeducation.
abstract: OBJECTIVE
  Approximately 14 000 pediatric out-of-hospital arrests occur annually. With this significant number and the diversity in the training backgrounds of medical providers, correct choice and placement of defibrillator pads are imperative to ensure maximum efficacy.
  
  
  METHODS
  One hundred fifty-two emergency medical care providers from 6 medical fields were recruited for the study. Each participant answered a series of questions to ascertain baseline knowledge of correct defibrillator pad choice and placement in 2 scenarios with mannequins weighted less than 15 kg and more than 15kg. After the testing, each participant received an educational intervention. Six months after the first phase, participants received a questionnaire to ascertain knowledge retention.
  
  
  RESULTS
  In the primary study phase, for correct pad choice for mannequins weighing less than 15 kg and more than 15 kg, overall results were 98% (95% confidence interval [CI], 94.1%-100%) and 38.8% (95% CI, 31.4%-46.8%), respectively. In the second phase, pad choices for mannequins weighing less than 15 kg and more than 15 kg were 77.3% (95% CI, 68.6%-84.2%) and 60% (95% CI, 47.7%-71.1%). The rates of correct pad placement during the initial phase for mannequins weighing less than 15 kg and more than 15 kg were 5.8% (95% CI, 2.8%-11.2%) and 25.7%, respectively (95% CI, 19.4%-35.7%). Rates for correct pad placement (<15-kg and >15-kg mannequins) improved in the second phase to 68.2% (95% CI, 56%-78.4%) and 71.2% (95% CI, 62.8%-81.5%).
  
  
  CONCLUSIONS
  Pediatric emergency providers have poor understanding of pad choice and placement. Emergency medical care providers for children who are educated about the correct defibrillator pad choices and placement have improved knowledge and can retain that knowledge for at least 6months.
authors: Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: kieshafraser@gmail.com.
authors: Kiesha N
authors: KN
authors: Fraser
authors: The Michael F. Altieri Fellowship in Pediatric Emergency Medicine, Falls Church VA; Virginia Commonwealth University School of Medicine, Inova Fairfax Hospital for Children, Falls Church, VA; Emergency Medicine Department, The George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: Maybelle.Kou@inova.org.
authors: Maybelle M
authors: MM
authors: Kou
authors: Virginia Commonwealth University School of Medicine, Inova Fairfax Hospital for Children, Falls Church, VA. Electronic address: howeljo@me.com.
authors: John M
authors: JM
authors: Howell
authors: Virginia Commonwealth University School of Medicine, Inova Fairfax Hospital for Children, Falls Church, VA; Emergency Medicine Department, The George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: kaidifullerton@gmail.com.
authors: Kaidi T
authors: KT
authors: Fullerton
authors: Virginia Commonwealth University School of Medicine, Inova Fairfax Hospital for Children, Falls Church, VA. Electronic address: c.sturek@gmail.com.
authors: Charles
authors: C
authors: Sturek
mesh_terms: D002648:Child; D047548:Defibrillators; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008348:Manikins; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy