Training volunteers to use defibrillators pays off

Non-medical people can be taught to safely and effectively use automated external defibrillators (AEDs) to treat cardiac arrests that occur outside the hospital.

According to results of the Public Access Defibrillation (PAD) Trial, training and equipping community volunteers to use AEDs doubled the number of patients who survived and were able to leave the hospital.

In the PAD Trial, Dr. Joseph P. Ornato, at the Virginia Commonwealth University Medical Center in Richmond, randomly chose community locations, such as shopping centers and recreational facilities, to take part in an emergency response program that involved either CPR only or CPR plus use of an AED. More than 19,000 volunteer lay responders were trained.

The study was conducted from 2000 to 2003, and the results are reported in this week's New England Journal of Medicine.

For the CPR-only group, there were 15 survivors among 107 definite cardiac arrest cases. For CPR-plus-AED, 30 of the 128 people with definite cardiac arrests survived. This difference was statistically significant, the authors note.

There were no inappropriate shocks administered, the investigators report. "Adverse events were rare and consisted mostly transient psychological trauma to the volunteers and stolen AEDs," they write.

In an interview with Reuters Health, Dr. Ornato pointed out that data are still being collected from this study to establish the cost per life saved.

"The catch is, the majority of cardiac arrests occur in homes," he noted, and providing AEDs in that setting represents an even more expensive proposition than making the devices available in public places.

"But now that our trial is done, the NIH has funded another trial as a follow-on, called the Home AED Trial, which is already running in some cities. It is similar to PAD except that the homes being selected have at least one resident who has survived a heart attack, which puts them at more than average risk of cardiac arrest."

SOURCE: New England Journal of Medicine, August 12, 2004.