1. Implementation of community-based public access defibrillation in the PAD trial
- Author
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Michael Proschan, Allan Holmes, Patricia McGraw, Joseph P. Ornato, David C. Goff, Ellen Demertsidis, Venard J. Campbell, Constance D. Jones, Gary Newton, Sandra S. Schmidt, Bruce Haynes, Laura Nolting, Mary Ann McBurnie, Heather Payne, Yves Rosenberg, Christopher W. Sparks, Jonathan Van Zile, Stephen Yahn, Chris von Briesen, Denise Griffiths, Margit Scholz, Brent Shaum, Brian D. Mahoney, Mark C. Henry, Michael Osur, Robert Swor, Max Harry Weil, Lynne D. Richardson, Anne Barry, Ella Huszti, Lisa O'Neill, Michael J. Domanski, Stephen Ehrlich, Ross E. Megargel, Brian MacGavin, Scott Johnson, Judith Paulsen, Graham Nichol, Louis Gonzales, H. Leon Greene, Robert B. Dunne, Jerris R. Hedges, Jerry Overton, Henry A. Feldman, Ray Lucas, William J. Groh, Art Kerr, Dennis Rabel, Myron L. Weisfeldt, Richard Moore, Kristen Bilicki, Brian K. Slater, Marge M. Lestarge, Patricia Lawson, Michael R. Sayre, Barbara Riegel, Frederick Ehlert, Lois A. Bosken, Richard A. Craven, Ronald G. Pirrallo, Deb Cordes, Andy R. Anton, Sarah Pennington, Patricia Burke, Neal Richmond, Thomas A. Mattioni, Nadia Douglas, Christine Grimmelsman, Christopher Shields, Lois Van Ottingham, Lisa Parmenter, Scott Compton, Alfred P. Hallstrom, Robert J. Zalenski, Laura Grabowski, Denise Simons-Morton, Krishnaswami Vijayaraghavan, Britta Myrin, Henry Thode, Richard W. Janisch, Robert D. Welch, George Arthur Wells, Tom P. Aufderheide, David B. Reed, Christopher Freyberg, Laurence McCullough, P. Jacob Varghese, David Feeny, Eleanor Schron, Robert E. O'Connor, N. Clay Mann, Margaret Amaya, Kathryn Irwin, Marcel E. Salive, Kimberly A. Deja, Christopher Burke, Rachel Knudson-Ballard, Sue Wood, Andrew H. Travers, Jim Christenson, Mohamud Daya, Sarah Nafziger, M. Bollinger, George Vasquez, Linda Asbury, Terri A. Schmidt, Shannon W. Stephens, Kimberlee Brown, Alice Birnbaum, Mary Ann Peberdy, Costas T. Lambrew, Mary D. Gunnels, Lynn Marie Mango, Alidene Doherty, Jerome Fleg, Debbie Morris, Jennifer Rokosh, Janyce Sanford, Craig J. Conrad, Robert Ledingham, Lisa M. Evans, Brenda Heisz, Kelly Schaffer, Lance B. Becker, Roland Webb, Thomas E. Terndrup, Ilene Wilets, Adrian Panylyk, Judy Powell, Lawrence H. Brown, Susan Alexandra Thompson, Kammy Jacobsen, R. O. Cummins, Mary Morris, David Hostler, Susan J. Bondurant, David J. Kitscha, Claudia Williams, Jennifer Holohan, Heather Brooks, Ruchir Sehra, Jonathan Jui, Edward R. Stapleton, Karen M. Kuntz, Allan Braslow, Lynn Wittwer, and Vince N. Mosesso more...
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Male ,Volunteers ,Canada ,Emergency Medical Services ,medicine.medical_treatment ,MEDLINE ,law.invention ,Age Distribution ,Randomized controlled trial ,law ,medicine ,Humans ,Attrition ,Cardiopulmonary resuscitation ,Community Health Services ,Sex Distribution ,Automated external defibrillator ,Public Sector ,business.industry ,Retraining ,Health Plan Implementation ,General Medicine ,Focus Groups ,Middle Aged ,medicine.disease ,Focus group ,United States ,Socioeconomic Factors ,Emergency Medicine ,Female ,Medical emergency ,business ,Qualitative research ,Defibrillators - Abstract
Background The Public Access Defibrillation (PAD) Trial was a randomized, controlled trial designed to measure survival to hospital discharge following out-of-hospital cardiac arrest (OOH-CA) in community facilities trained and equipped to provide PAD, compared with community facilities trained to provide cardiopulmonary resuscitation (CPR) without any capacity for defibrillation. Objectives To report the implementation of community-based lay responder emergency response programs in 1,260 participating facilities recruited for the PAD Trial in the United States and Canada. Methods This was a descriptive study of the characteristics of participating facilities, volunteers, and automated external defibrillator (AED) placements compiled by the PAD Trial, and a qualitative study of factors that facilitated or impeded implementation of emergency lay responder programs using focus groups of PAD Trial site coordinators. Results The PAD Trial enrolled 1,260 community facilities (14.8% residential), with 20,400 lay volunteers (mean +/- standard deviation = 13.4 +/- 10.7 per facility) trained to respond to OOH-CA. The 598 locations randomized to receive AEDs required 2.7 +/- 1.8 AEDs per facility. Volunteer attrition was high, 36% after two years. Barriers to recruitment and implementation included identification of appropriate "at-risk" facilities, lack of interest or fear of litigation by a facility key decision maker, lack of motivated potential volunteer responders, training and retraining resource requirements, and lack of an existing communication/response infrastructure. Conclusions These data indicate that implementation of community-based lay responder programs is feasible in many types of facilities, although these programs require substantial resources and commitment, and many barriers to implementation of effective PAD programs exist. more...
- Published
- 2005