(Circulation. 1999;100:1703-1707.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Comparison of Naive Sixth-Grade Children With Trained Professionals in the Use of an Automated External Defibrillator
From the Division of Cardiology, Department of Medicine, University of Washington, Seattle, Wash.
Correspondence to Gust H. Bardy, MD, Box 356422, University of Washington Medical Center, Seattle, WA 98195-6422. E-mail gbardy{at}u.washington.edu
Background—Survival after out-of-hospital cardiac arrest (OHCA) is strongly influenced by time to defibrillation. Wider availability of automated external defibrillators (AEDs) may decrease response times but only with increased lay use. Consequently, this study endeavored to improve our understanding of AED use in naive users by measuring times to shock and appropriateness of pad location. We chose sixth-grade students to simulate an extreme circumstance of unfamiliarity with the problem of OHCA and defibrillation. The children's AED use was then compared with that of professionals.
Methods and Results—With the use of a mock cardiac arrest scenario, AED use by 15 children was compared with that of 22 emergency medical technicians (EMTs) or paramedics. The primary end point was time from entry onto the cardiac arrest scene to delivery of the shock into simulated ventricular fibrillation. The secondary end point was appropriateness of pad placement. All subject performances were videotaped to assess safety of use and compliance with AED prompts to remain clear of the mannequin during shock delivery. Mean time to defibrillation was 90±14 seconds (range, 69 to 111 seconds) for the children and 67±10 seconds (range, 50 to 87 seconds) for the EMTs/paramedics (P<0.0001). Electrode pad placement was appropriate for all subjects. All remained clear of the "patient" during shock delivery.
Conclusions—During mock cardiac arrest, the speed of AED use by untrained children is only modestly slower than that of professionals. The difference between the groups is surprisingly small, considering the naïveté of the children as untutored first-time users. These findings suggest that widespread use of AEDs will require only modest training.
Key Words: defibrillation • fibrillation • death, sudden • cardiopulmonary resuscitation
This article has been cited by other articles:
 |
|
 |
|
  S. Dichtwald, I. Matot, and S. Einav Improving the Outcome of In-Hospital Cardiac Arrest: The Importance of Being EARNEST Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2009; 13(1): 19 - 30. [Abstract] [PDF]
|
|
|
|
 |
|
 V. L. Vetter, J. Elia, C. Erickson, S. Berger, N. Blum, K. Uzark, and C. L. Webb Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing Circulation, May 6, 2008; 117(18): 2407 - 2423. [Full Text] [PDF]
|
|
|
|
 |
|
 K. B. Mitchell, L. Gugerty, and E. Muth Effects of Brief Training on Use of Automated External Defibrillators by People Without Medical Expertise Human Factors: The Journal of the Human Factors and Ergonomics Society, April 1, 2008; 50(2): 301 - 310. [Abstract] [PDF]
|
|
|
|
|
|
N.A. M. Estes III Prediction and Prevention of Sudden Cardiac Arrest: Lessons Learned in Schools Circulation, September 18, 2007; 116(12): 1341 - 1343. [Full Text] [PDF]
|
|
|
|
|
|
F. A. Drews, P. Picciano, J. Agutter, N. Syroid, D. R. Westenskow, and D. L. Strayer Development and Evaluation of a Just-in-Time Support System Human Factors: The Journal of the Human Factors and Ergonomics Society, June 1, 2007; 49(3): 543 - 551. [Abstract] [PDF]
|
|
|
|
 |
|
 J. S. Shah and W. H. Maisel Recalls and safety alerts affecting automated external defibrillators. JAMA, August 9, 2006; 296(6): 655 - 660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Israel and S. H. Hohnloser Automated external defibrillation in emergency medical systems: what has been achieved and where to go? Eur. Heart J., March 1, 2006; 27(5): 508 - 509. [Full Text] [PDF]
|
|
|
|
|
|
H. England, P. S. Weinberg, and N. A. M. Estes III The Automated External Defibrillator: Clinical Benefits and Legal Liability JAMA, February 8, 2006; 295(6): 687 - 690. [Full Text] [PDF]
|
|
|
|
|
|
Part 8: Interdisciplinary Topics Circulation, November 29, 2005; 112(22_suppl): III-100 - III-108. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kyller and D. Johnstone A 2-Tiered Approach to In-Hospital Defibrillation: Nurses Respond to a Trial of Using Automated External Defibrillators as Part of a Code-Team Protocol Crit. Care Nurse, August 1, 2005; 25(4): 25 - 33. [Full Text] [PDF]
|
|
|
|
 |
|
 E. E. Coris, F. Sahebzamani, S. Walz, and A. M. Ramirez Automated External Defibrillators in National Collegiate Athletic Association Division I Athletics Am. J. Sports Med., April 1, 2004; 32(3): 744 - 754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Cram, A. M. Fendrick, S. Vijan, P. W. Groeneveld, S. Caffrey-Villari, and P. E. Pepe Public Use of Automated External Defibrillators N. Engl. J. Med., February 20, 2003; 348(8): 755 - 756. [Full Text] [PDF]
|
|
|
|
|
|
S. L. Caffrey, P. J. Willoughby, P. E. Pepe, and L. B. Becker Public Use of Automated External Defibrillators N. Engl. J. Med., October 17, 2002; 347(16): 1242 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. S. Takata, R. L. Page, and J. A. Joglar Automated External Defibrillators: Technical Considerations and Clinical Promise Ann Intern Med, December 4, 2001; 135(11): 990 - 998. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Sotoodehnia, A. Zivin, G. H Bardy, and D. S Siscovick Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research Cardiovasc Res, May 1, 2001; 50(2): 197 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Marenco, P. J. Wang, M. S. Link, M. K. Homoud, and N. A. M. Estes III Improving Survival From Sudden Cardiac Arrest: The Role of the Automated External Defibrillator JAMA, March 7, 2001; 285(9): 1193 - 1200. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Page, J. A. Joglar, R. C. Kowal, J. D. Zagrodzky, L. L. Nelson, K. Ramaswamy, S. J. Barbera, M. H. Hamdan, and D. K. McKenas Use of Automated External Defibrillators by a U.S. Airline N. Engl. J. Med., October 26, 2000; 343(17): 1210 - 1216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Robertson Sudden Death from Cardiac Arrest -- Improving the Odds N. Engl. J. Med., October 26, 2000; 343(17): 1259 - 1260. [Full Text]
|
|
|
|
|
|
M. S. Eisenberg Is It Time for Over-the-Counter Defibrillators? JAMA, September 20, 2000; 284(11): 1435 - 1438. [Full Text] [PDF]
|
|
|
|
|
|
J. Brown and A. L. Kellerman The Shocking Truth About Automated External Defibrillators JAMA, September 20, 2000; 284(11): 1438 - 1441. [Full Text] [PDF]
|
|
|
|
 |
|
 Sixth-Graders Can Operate a Defibrillator Without Any Training Journal Watch Emergency Medicine, December 1, 1999; 1999(1201): 24 - 24. [Full Text]
|
|
|
|
 |
|
 Automated External Defibrillators Are Easy to Use Journal Watch (General), October 29, 1999; 1999(1029): 1 - 1. [Full Text]
|
|