Skill acquisition and retention in automated external defibrillator (AED) use and CPR by lay responders: a prospective study
Introduction
The use of automated external defibrillators (AEDs) in community programmes is becoming widespread [1], [2], [3], [4], [5]. However, few reports have been published on the effectiveness of training programmes for lay persons using AEDs, and no general agreement has been reached on the optimum intervals for refresher training. In accordance with government policy [6], the Department of Health in England has placed AEDs in busy public places such as airports and railway stations [7]. We were commissioned to assess the effectiveness of a 4-h training course in basic life support and AED use, the subsequent degree of skill decay after 6 months, and the value of refresher training at that time. Our findings have implications for all training programmes for responders who are not health care professionals but who may be deployed to a cardiac arrest to use an AED and provide cardio-pulmonary resuscitation (CPR).
Section snippets
Subjects
Airport employees aged 18 years or over who volunteered to take part in the Department of Health, England National Defibrillator Programme. Demographics are reported in Table 1.
Test scenario
Before initial training, participants were asked to manage a standardised manikin simulation of a cardiac arrest. During the assessment, an AED was available but no prompt or other encouragement to use it was given. The scenario used had previously been tested in a pilot study with three groups of five participants.
Demographics
Of the 132 subjects approached to participate in the research, 112 completed both pre- and post-initial training assessments. Seventy-six subsequently undertook refresher training and completed further assessments both before and after this class. Demographic data are reported in Table 1.
The dropout rate of subjects between the initial and refresher classes was considerable despite attempts to encourage all trainees to attend both sessions using letters and telephone contact. There were no
Discussion
Automated external defibrillators have been available for over 20 years [15], but only recently has their true potential begun to be realised. AEDs have made early defibrillation more generally available within the community [16], [17], [18], and in England the Department of Health has placed nearly 700 in busy public places and arranged training for lay employees working at the site who are most likely to be in a position to use them. There have been few reports about the effectiveness of
Acknowledgements
The authors gratefully acknowledge Jeremy Johnstone, Ian Jones, and David Morris, seconded from the Welsh Ambulance Service NHS Trust as Research Assistants, for their help with the assessments, and George Murphy who made these staff available. Bristol International Airport accommodated the needs of the study specifically, and Symon Clifford and Ivor Valentine of the Airport Fire Service co-ordinated the training courses and trainee availability. We are particularly grateful to Sian Davies from
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