Implementation of community-based public access defibrillation in the PAD trial

Lynne D. Richardson; Mary D. Gunnels; William J. Groh; Mary Ann Peberdy; Sarah Pennington; Ilene Wilets; Venard Campbell; Lois Van Ottingham; Mary Ann McBurnie; Joseph P. Ornato; Myron Weisfeldt; Michael R. Sayre; Barbara Riegel; Krishnaswami Vijayaraghavan; Thomas Mattioni; Claudia Williams; Andy R. Anton; Constance D. Jones; Stephen Yahn; Dennis Rabel; Robert E. O'Connor; Patricia McGraw; Melissa Bollinger; Ross E. Megargel; Alfred P. Hallstrom; H. Leon Greene; Judy Powell; Alice Birnbaum; Robert B. Ledingham; Richard Moore; Mary Morris; Margit Scholz; Art Kerr; Costas T. Lambrew; David C. Goff; Laurence McCullough; Louis Gonzales; Henry A. Feldman; Allan Braslow; Richard A. Craven; Lois A. Bosken; Patricia Burke; Judith Paulsen; Gary Newton; Graham Nichol; George Wells; Ella Huszti; Jennifer Rokosh; Debbie Morris; Karen Kuntz; Brian D. Mahoney; Rachel Knudson-Ballard; George Vasquez; William J. Groh; Deb Cordes; Susan J. Bondurant; Max Harry Weil; N. Clay Mann; Brent Shaum; Kimberlee Brown; Kammy Jacobsen; Ruchir Sehra; Tom P. Aufderheide; Ronald G. Pirrallo; Craig J. Conrad; David J. Kitscha; Christopher W. Sparks; Chris Von Briesen; Kimberly A. Deja; Marge M. Lestarge; Richard W. Janisch; Sandra S. Schmidt; Lisa Parmenter; Laura Grabowski; Stephen Ehrlich; Bruce Haynes; Linda Asbury; Margaret Amaya; Jennifer Holohan; Frederick Ehlert; Christopher Freyberg; Neal Richmond; Christopher Shields; Eleanor B. Schron; Jerome Fleg; Michael J. Domanski; Michael Proschan; Yves Rosenberg; Lisa O'Neill; Denise Simons-Morton; Marcel E. Salive; Mohamud Daya; Mary D. Gunnels; Jerris R. Hedges; Jonathan Jui; Terri Schmidt; Lynn Wittwer; Heather Brooks; Christopher Burke; Denise Griffiths; Michael Osur; Brian MacGavin; Britta Myrin; Richard O. Cummins; Alidene Doherty; Sue Thompson; Sue Wood; Jim Christenson; Sarah Pennington; Allan Holmes; Heather Payne; Roland Webb; Nadia Douglas; Patricia Lawson; Mark C. Henry; Scott Johnson; Henry Thode; Edward R. Stapleton; David B. Reed; Lawrence H. Brown; Lisa M. Evans; P. Jacob Varghese; Ray Lucas; Thomas E. Terndrup; Shannon Stephens; Sarah Nafziger; Janyce Sanford; David Feeny; Andrew Travers; Adrian Panylyk; Kathryn Irwin; Brenda Heisz; Lance B. Becker; Anne Barry; Ellen Demertsidis; Jonathan Van Zile; Christine Grimmelsman; Laura Nolting; Vince N. Mosesso; Brian K. Slater; Venard J. Campbell; David Hostler; Jerry Overton; Kelly Schaffer; Robert Zalenski; Scott Compton; Robert Dunne; Robert Swor; Robert Welch; Lynn Marie Mango; Kristen Bilicki

doi:10.1197/j.aem.2005.03.525

Implementation of community-based public access defibrillation in the PAD trial

Lynne D. Richardson, Mary D. Gunnels, William J. Groh, Mary Ann Peberdy, Sarah Pennington, Ilene Wilets, Venard Campbell, Lois Van Ottingham, Mary Ann McBurnie, Joseph P. Ornato, Myron Weisfeldt, Michael R. Sayre, Barbara Riegel, Krishnaswami Vijayaraghavan, Thomas Mattioni, Claudia Williams, Andy R. Anton, Constance D. Jones, Stephen Yahn, Dennis RabelRobert E. O'Connor, Patricia McGraw, Melissa Bollinger, Ross E. Megargel, Alfred P. Hallstrom, H. Leon Greene, Judy Powell, Alice Birnbaum, Robert B. Ledingham, Richard Moore, Mary Morris, Margit Scholz, Art Kerr, Costas T. Lambrew, David C. Goff, Laurence McCullough, Louis Gonzales, Henry A. Feldman, Allan Braslow, Richard A. Craven, Lois A. Bosken, Patricia Burke, Judith Paulsen, Gary Newton, Graham Nichol, George Wells, Ella Huszti, Jennifer Rokosh, Debbie Morris, Karen Kuntz, Brian D. Mahoney, Rachel Knudson-Ballard, George Vasquez, William J. Groh, Deb Cordes, Susan J. Bondurant, Max Harry Weil, N. Clay Mann, Brent Shaum, Kimberlee Brown, Kammy Jacobsen, Ruchir Sehra, Tom P. Aufderheide, Ronald G. Pirrallo, Craig J. Conrad, David J. Kitscha, Christopher W. Sparks, Chris Von Briesen, Kimberly A. Deja, Marge M. Lestarge, Richard W. Janisch, Sandra S. Schmidt, Lisa Parmenter, Laura Grabowski, Stephen Ehrlich, Bruce Haynes, Linda Asbury, Margaret Amaya, Jennifer Holohan, Frederick Ehlert, Christopher Freyberg, Neal Richmond, Christopher Shields, Eleanor B. Schron, Jerome Fleg, Michael J. Domanski, Michael Proschan, Yves Rosenberg, Lisa O'Neill, Denise Simons-Morton, Marcel E. Salive, Mohamud Daya, Mary D. Gunnels, Jerris R. Hedges, Jonathan Jui, Terri Schmidt, Lynn Wittwer, Heather Brooks, Christopher Burke, Denise Griffiths, Michael Osur, Brian MacGavin, Britta Myrin, Richard O. Cummins, Alidene Doherty, Sue Thompson, Sue Wood, Jim Christenson, Sarah Pennington, Allan Holmes, Heather Payne, Roland Webb, Nadia Douglas, Patricia Lawson, Mark C. Henry, Scott Johnson, Henry Thode, Edward R. Stapleton, David B. Reed, Lawrence H. Brown, Lisa M. Evans, P. Jacob Varghese, Ray Lucas, Thomas E. Terndrup, Shannon Stephens, Sarah Nafziger, Janyce Sanford, David Feeny, Andrew Travers, Adrian Panylyk, Kathryn Irwin, Brenda Heisz, Lance B. Becker, Anne Barry, Ellen Demertsidis, Jonathan Van Zile, Christine Grimmelsman, Laura Nolting, Vince N. Mosesso, Brian K. Slater, Venard J. Campbell, David Hostler, Jerry Overton, Kelly Schaffer, Robert Zalenski, Scott Compton, Robert Dunne, Robert Swor, Robert Welch, Lynn Marie Mango, Kristen Bilicki

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

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.

Original language	English (US)
Pages (from-to)	688-697
Number of pages	10
Journal	Academic Emergency Medicine
Volume	12
Issue number	8
DOIs	https://doi.org/10.1197/j.aem.2005.03.525
State	Published - Aug 2005
Externally published	Yes

Keywords

Automated external defibrillators
Cardiac arrest
Cardiopulmonary resuscitation
Defibrillation
Out-of-hospital cardiac arrest
Public access defibrillation

ASJC Scopus subject areas

Emergency Medicine

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10.1197/j.aem.2005.03.525

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Richardson, L. D., Gunnels, M. D., Groh, W. J., Peberdy, M. A., Pennington, S., Wilets, I., Campbell, V., Van Ottingham, L., McBurnie, M. A., Ornato, J. P., Weisfeldt, M., Sayre, M. R., Riegel, B., Vijayaraghavan, K., Mattioni, T., Williams, C., Anton, A. R., Jones, C. D., Yahn, S., ... Bilicki, K. (2005). Implementation of community-based public access defibrillation in the PAD trial. Academic Emergency Medicine, 12(8), 688-697. https://doi.org/10.1197/j.aem.2005.03.525

Richardson, LD, Gunnels, MD, Groh, WJ, Peberdy, MA, Pennington, S, Wilets, I, Campbell, V, Van Ottingham, L, McBurnie, MA, Ornato, JP, Weisfeldt, M, Sayre, MR, Riegel, B, Vijayaraghavan, K, Mattioni, T, Williams, C, Anton, AR, Jones, CD, Yahn, S, Rabel, D, O'Connor, RE, McGraw, P, Bollinger, M, Megargel, RE, Hallstrom, AP, Greene, HL, Powell, J, Birnbaum, A, Ledingham, RB, Moore, R, Morris, M, Scholz, M, Kerr, A, Lambrew, CT, Goff, DC, McCullough, L, Gonzales, L, Feldman, HA, Braslow, A, Craven, RA, Bosken, LA, Burke, P, Paulsen, J, Newton, G, Nichol, G, Wells, G, Huszti, E, Rokosh, J, Morris, D, Kuntz, K, Mahoney, BD, Knudson-Ballard, R, Vasquez, G, Groh, WJ, Cordes, D, Bondurant, SJ, Weil, MH, Mann, NC, Shaum, B, Brown, K, Jacobsen, K, Sehra, R, Aufderheide, TP, Pirrallo, RG, Conrad, CJ, Kitscha, DJ, Sparks, CW, Von Briesen, C, Deja, KA, Lestarge, MM, Janisch, RW, Schmidt, SS, Parmenter, L, Grabowski, L, Ehrlich, S, Haynes, B, Asbury, L, Amaya, M, Holohan, J, Ehlert, F, Freyberg, C, Richmond, N, Shields, C, Schron, EB, Fleg, J, Domanski, MJ, Proschan, M, Rosenberg, Y, O'Neill, L, Simons-Morton, D, Salive, ME, Daya, M, Gunnels, MD, Hedges, JR, Jui, J, Schmidt, T, Wittwer, L, Brooks, H, Burke, C, Griffiths, D, Osur, M, MacGavin, B, Myrin, B, Cummins, RO, Doherty, A, Thompson, S, Wood, S, Christenson, J, Pennington, S, Holmes, A, Payne, H, Webb, R, Douglas, N, Lawson, P, Henry, MC, Johnson, S, Thode, H, Stapleton, ER, Reed, DB, Brown, LH, Evans, LM, Varghese, PJ, Lucas, R, Terndrup, TE, Stephens, S, Nafziger, S, Sanford, J, Feeny, D, Travers, A, Panylyk, A, Irwin, K, Heisz, B, Becker, LB, Barry, A, Demertsidis, E, Van Zile, J, Grimmelsman, C, Nolting, L, Mosesso, VN, Slater, BK, Campbell, VJ, Hostler, D, Overton, J, Schaffer, K, Zalenski, R, Compton, S, Dunne, R, Swor, R, Welch, R, Mango, LM & Bilicki, K 2005, 'Implementation of community-based public access defibrillation in the PAD trial', Academic Emergency Medicine, vol. 12, no. 8, pp. 688-697. https://doi.org/10.1197/j.aem.2005.03.525

@article{30b5d924c22d47e2ad9784fb095604b9,

title = "Implementation of community-based public access defibrillation in the PAD trial",

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.",

keywords = "Automated external defibrillators, Cardiac arrest, Cardiopulmonary resuscitation, Defibrillation, Out-of-hospital cardiac arrest, Public access defibrillation",

author = "Richardson, {Lynne D.} and Gunnels, {Mary D.} and Groh, {William J.} and Peberdy, {Mary Ann} and Sarah Pennington and Ilene Wilets and Venard Campbell and {Van Ottingham}, Lois and McBurnie, {Mary Ann} and Ornato, {Joseph P.} and Myron Weisfeldt and Sayre, {Michael R.} and Barbara Riegel and Krishnaswami Vijayaraghavan and Thomas Mattioni and Claudia Williams and Anton, {Andy R.} and Jones, {Constance D.} and Stephen Yahn and Dennis Rabel and O'Connor, {Robert E.} and Patricia McGraw and Melissa Bollinger and Megargel, {Ross E.} and Hallstrom, {Alfred P.} and Greene, {H. Leon} and Judy Powell and Alice Birnbaum and Ledingham, {Robert B.} and Richard Moore and Mary Morris and Margit Scholz and Art Kerr and Lambrew, {Costas T.} and Goff, {David C.} and Laurence McCullough and Louis Gonzales and Feldman, {Henry A.} and Allan Braslow and Craven, {Richard A.} and Bosken, {Lois A.} and Patricia Burke and Judith Paulsen and Gary Newton and Graham Nichol and George Wells and Ella Huszti and Jennifer Rokosh and Debbie Morris and Karen Kuntz and Mahoney, {Brian D.} and Rachel Knudson-Ballard and George Vasquez and Groh, {William J.} and Deb Cordes and Bondurant, {Susan J.} and Weil, {Max Harry} and Mann, {N. Clay} and Brent Shaum and Kimberlee Brown and Kammy Jacobsen and Ruchir Sehra and Aufderheide, {Tom P.} and Pirrallo, {Ronald G.} and Conrad, {Craig J.} and Kitscha, {David J.} and Sparks, {Christopher W.} and {Von Briesen}, Chris and Deja, {Kimberly A.} and Lestarge, {Marge M.} and Janisch, {Richard W.} and Schmidt, {Sandra S.} and Lisa Parmenter and Laura Grabowski and Stephen Ehrlich and Bruce Haynes and Linda Asbury and Margaret Amaya and Jennifer Holohan and Frederick Ehlert and Christopher Freyberg and Neal Richmond and Christopher Shields and Schron, {Eleanor B.} and Jerome Fleg and Domanski, {Michael J.} and Michael Proschan and Yves Rosenberg and Lisa O'Neill and Denise Simons-Morton and Salive, {Marcel E.} and Mohamud Daya and Gunnels, {Mary D.} and Hedges, {Jerris R.} and Jonathan Jui and Terri Schmidt and Lynn Wittwer and Heather Brooks and Christopher Burke and Denise Griffiths and Michael Osur and Brian MacGavin and Britta Myrin and Cummins, {Richard O.} and Alidene Doherty and Sue Thompson and Sue Wood and Jim Christenson and Sarah Pennington and Allan Holmes and Heather Payne and Roland Webb and Nadia Douglas and Patricia Lawson and Henry, {Mark C.} and Scott Johnson and Henry Thode and Stapleton, {Edward R.} and Reed, {David B.} and Brown, {Lawrence H.} and Evans, {Lisa M.} and Varghese, {P. Jacob} and Ray Lucas and Terndrup, {Thomas E.} and Shannon Stephens and Sarah Nafziger and Janyce Sanford and David Feeny and Andrew Travers and Adrian Panylyk and Kathryn Irwin and Brenda Heisz and Becker, {Lance B.} and Anne Barry and Ellen Demertsidis and {Van Zile}, Jonathan and Christine Grimmelsman and Laura Nolting and Mosesso, {Vince N.} and Slater, {Brian K.} and Campbell, {Venard J.} and David Hostler and Jerry Overton and Kelly Schaffer and Robert Zalenski and Scott Compton and Robert Dunne and Robert Swor and Robert Welch and Mango, {Lynn Marie} and Kristen Bilicki",

note = "Funding Information: Supported by Contract #N01–HC–95177 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; American Heart Association, Dallas, TX; Medtronic, Incorporated, Minneapolis, MN; Guidant Foundation, Indianapolis, IN; Cardiac Science/SurVivaLink, Incorporated, Minneapolis, MN; Medtronic Physio-Control Corporation, Redmond, WA; Philips Medical Systems/Heartstream, Seattle, WA; and Laerdal Medical Corporation, Wappingers Falls, NY. ",

year = "2005",

month = aug,

doi = "10.1197/j.aem.2005.03.525",

language = "English (US)",

volume = "12",

pages = "688--697",

journal = "Academic Emergency Medicine",

issn = "1069-6563",

publisher = "Wiley-Blackwell",

number = "8",

}

TY - JOUR

T1 - Implementation of community-based public access defibrillation in the PAD trial

AU - Richardson, Lynne D.

AU - Gunnels, Mary D.

AU - Groh, William J.

AU - Peberdy, Mary Ann

AU - Pennington, Sarah

AU - Wilets, Ilene

AU - Campbell, Venard

AU - Van Ottingham, Lois

AU - McBurnie, Mary Ann

AU - Ornato, Joseph P.

AU - Weisfeldt, Myron

AU - Sayre, Michael R.

AU - Riegel, Barbara

AU - Vijayaraghavan, Krishnaswami

AU - Mattioni, Thomas

AU - Williams, Claudia

AU - Anton, Andy R.

AU - Jones, Constance D.

AU - Yahn, Stephen

AU - Rabel, Dennis

AU - O'Connor, Robert E.

AU - McGraw, Patricia

AU - Bollinger, Melissa

AU - Megargel, Ross E.

AU - Hallstrom, Alfred P.

AU - Greene, H. Leon

AU - Powell, Judy

AU - Birnbaum, Alice

AU - Ledingham, Robert B.

AU - Moore, Richard

AU - Morris, Mary

AU - Scholz, Margit

AU - Kerr, Art

AU - Lambrew, Costas T.

AU - Goff, David C.

AU - McCullough, Laurence

AU - Gonzales, Louis

AU - Feldman, Henry A.

AU - Braslow, Allan

AU - Craven, Richard A.

AU - Bosken, Lois A.

AU - Burke, Patricia

AU - Paulsen, Judith

AU - Newton, Gary

AU - Nichol, Graham

AU - Wells, George

AU - Huszti, Ella

AU - Rokosh, Jennifer

AU - Morris, Debbie

AU - Kuntz, Karen

AU - Mahoney, Brian D.

AU - Knudson-Ballard, Rachel

AU - Vasquez, George

AU - Groh, William J.

AU - Cordes, Deb

AU - Bondurant, Susan J.

AU - Weil, Max Harry

AU - Mann, N. Clay

AU - Shaum, Brent

AU - Brown, Kimberlee

AU - Jacobsen, Kammy

AU - Sehra, Ruchir

AU - Aufderheide, Tom P.

AU - Pirrallo, Ronald G.

AU - Conrad, Craig J.

AU - Kitscha, David J.

AU - Sparks, Christopher W.

AU - Von Briesen, Chris

AU - Deja, Kimberly A.

AU - Lestarge, Marge M.

AU - Janisch, Richard W.

AU - Schmidt, Sandra S.

AU - Parmenter, Lisa

AU - Grabowski, Laura

AU - Ehrlich, Stephen

AU - Haynes, Bruce

AU - Asbury, Linda

AU - Amaya, Margaret

AU - Holohan, Jennifer

AU - Ehlert, Frederick

AU - Freyberg, Christopher

AU - Richmond, Neal

AU - Shields, Christopher

AU - Schron, Eleanor B.

AU - Fleg, Jerome

AU - Domanski, Michael J.

AU - Proschan, Michael

AU - Rosenberg, Yves

AU - O'Neill, Lisa

AU - Simons-Morton, Denise

AU - Salive, Marcel E.

AU - Daya, Mohamud

AU - Gunnels, Mary D.

AU - Hedges, Jerris R.

AU - Jui, Jonathan

AU - Schmidt, Terri

AU - Wittwer, Lynn

AU - Brooks, Heather

AU - Burke, Christopher

AU - Griffiths, Denise

AU - Osur, Michael

AU - MacGavin, Brian

AU - Myrin, Britta

AU - Cummins, Richard O.

AU - Doherty, Alidene

AU - Thompson, Sue

AU - Wood, Sue

AU - Christenson, Jim

AU - Pennington, Sarah

AU - Holmes, Allan

AU - Payne, Heather

AU - Webb, Roland

AU - Douglas, Nadia

AU - Lawson, Patricia

AU - Henry, Mark C.

AU - Johnson, Scott

AU - Thode, Henry

AU - Stapleton, Edward R.

AU - Reed, David B.

AU - Brown, Lawrence H.

AU - Evans, Lisa M.

AU - Varghese, P. Jacob

AU - Lucas, Ray

AU - Terndrup, Thomas E.

AU - Stephens, Shannon

AU - Nafziger, Sarah

AU - Sanford, Janyce

AU - Feeny, David

AU - Travers, Andrew

AU - Panylyk, Adrian

AU - Irwin, Kathryn

AU - Heisz, Brenda

AU - Becker, Lance B.

AU - Barry, Anne

AU - Demertsidis, Ellen

AU - Van Zile, Jonathan

AU - Grimmelsman, Christine

AU - Nolting, Laura

AU - Mosesso, Vince N.

AU - Slater, Brian K.

AU - Campbell, Venard J.

AU - Hostler, David

AU - Overton, Jerry

AU - Schaffer, Kelly

AU - Zalenski, Robert

AU - Compton, Scott

AU - Dunne, Robert

AU - Swor, Robert

AU - Welch, Robert

AU - Mango, Lynn Marie

AU - Bilicki, Kristen

N1 - Funding Information: Supported by Contract #N01–HC–95177 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; American Heart Association, Dallas, TX; Medtronic, Incorporated, Minneapolis, MN; Guidant Foundation, Indianapolis, IN; Cardiac Science/SurVivaLink, Incorporated, Minneapolis, MN; Medtronic Physio-Control Corporation, Redmond, WA; Philips Medical Systems/Heartstream, Seattle, WA; and Laerdal Medical Corporation, Wappingers Falls, NY.

PY - 2005/8

Y1 - 2005/8

N2 - 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.

AB - 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.

KW - Automated external defibrillators

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Defibrillation

KW - Out-of-hospital cardiac arrest

KW - Public access defibrillation

UR - http://www.scopus.com/inward/record.url?scp=22544482961&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22544482961&partnerID=8YFLogxK

U2 - 10.1197/j.aem.2005.03.525

DO - 10.1197/j.aem.2005.03.525

M3 - Article

C2 - 16079421

AN - SCOPUS:22544482961

SN - 1069-6563

VL - 12

SP - 688

EP - 697

JO - Academic Emergency Medicine

JF - Academic Emergency Medicine

IS - 8

ER -

Implementation of community-based public access defibrillation in the PAD trial

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