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Public access defibrillation (PAD) programs are a major goal of the American Heart Association (AHA) to ensure that automated external defibrillators and trained lay rescuers are available in public areas where sudden cardiac arrest (SCA) is likely to occur. The Johnson County Early Defibrillation Task Force (JCEDTF) is a volunteer organization which distributed AEDs throughout Johnson County, Iowa. JCEDTF was responsible for initial training but ongoing support was the responsibility of each site.The purpose of this study was to evaluate compliance of community PAD sites to recommendations for site maintenance as proposed by the American Heart Association (AHA).Thirty-two surveys were distributed to community PAD sites that received assistance from JCEDTF. PAD sites were categorized into business, educational, or community sites. A twenty-five point scoring system to assess PDA programs was developed based on AHA recommendations. On-site evaluations were conducted to verify survey results and assess barriers to an effective PAD site. Differences among the three categories were measured with ANOVA.No site was able to comply with all the AHA guidelines for a PAD site. The mean score among all sites was 57% of possible points with no significant differences among the three categories. Business sites were more compliant with ongoing training compared to educational and community sites (p0.022).Community PAD sites in Johnson County currently do not comply with the recommendations for effective PAD sites. After initial training and establishment of community PAD sites, better methods for assuring ongoing training and maintenance are needed for sites to be effective.

Introduction The Public Access Defibrillation (PAD) Trial demonstrated improved survival of cardiac arrest victims when automated external defibrillators (AEDs) were combined with CPR by lay responders. These PAD sites incorporated American Heart Association (AHA) recommended elements of a PAD site and the volunteer responders received refresher CPR/AED training. It is unknown if typical community PAD sites maintain these elements after initial program development. The Johnson County Early Defibrillation Task Force (JCEDTF) in Johnson County, IA distributed AEDs throughout the county in 2002. CPR training was provided at program initiation. The purpose of this study was to evaluate the PAD sites 5 years later to assess compliance with AHA recommendations. Methods A 25 point scoring system was developed to assign numerical values to the components of a PAD site: planned and practiced response, links with local EMS, and training of rescuers. Surveys were mailed to all 39 PAD sites. Site visits with tours were conducted at each the site to confirm the survey. Sites were grouped into educational, community, or business sites. Results Thirty two surveys were returned (response rate 82%): 5 educational sites, 13 business and industrial sites and 14 community sites. The Table shows the percentage of points that each group achieved for the components of an AED program. No site had incorporated all the recommended elements: the best sites included only 2/3 of the recommendations. There was a statistical difference in CPR training, with business and industrial sites performing best. Community sites were particularly weak with CPR training. Conclusions PAD sites incorporate approximately half of the elements of an effective PAD program. Business and industrial sites perform slightly better than educational or community sites. CPR training and EMS links are the poorest areas of compliance. These results may indicate that the effectiveness of a PAD site may diminish with time. Table: Percentage of Achieved Points