Dataset Information

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study.

ABSTRACT:

Background

Timely use of an automated external defibrillator (AED) improves outcomes in sudden cardiopulmonary arrest (SCA). Our project aims were to: 1) identify the barriers to optimal AED use in the Québec City area elementary schools; 2) create targeted educational material regarding AEDs; and 3) measure the impact of the teaching module.

Methods

Using a quality improvement in health-care framework, a survey exploring the barriers to AED use was sent to 139 elementary schools. We then developed a video teaching module on using AEDs to address these barriers. A convenience sample of 92 elementary school professionals participated in a mock scenario. Metrics related to AED use were assessed at baseline and after completing the post-teaching module. The primary outcome was the time to first shock and secondary outcomes consisted of evaluating the completion of each step required for safe and effective AED use.

Results

The barrier analysis survey received a response rate of 52.5%. Most schools reported having an AED (95%), but 48.6% indicated that no formal training was offered. After the teaching module, the appropriate use of the AED in an SCA simulation improved from 53% to 92% (P < 0.001). The average time elapsed before first shock was 66 (95% confidence interval [CI], 63-70) seconds at baseline compared with 47 (95% CI, 45-49) seconds post-teaching module (P < 0.001).

Conclusions

Lack of training, the main barrier to optimal use of AEDs in elementary schools, can be addressed through a brief video teaching module, thus improving the ability to deliver timely and effective defibrillation.

SUBMITTER: Blanchard PG

PROVIDER: S-EPMC10642092 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study.

Blanchard Pierre-Gilles PG Graham Johann M I JMI Gauvin Vincent V Lanoue Marie-Pier MP Péloquin Fannie F Bertrand Isabelle I Ulrich Singbo Mahukpe Narcisse MN Poirier Paul P Émond Marcel M Mercier Eric E

CJC pediatric and congenital heart disease 20220202 1

<h4>Background</h4>Timely use of an automated external defibrillator (AED) improves outcomes in sudden cardiopulmonary arrest (SCA). Our project aims were to: 1) identify the barriers to optimal AED use in the Québec City area elementary schools; 2) create targeted educational material regarding AEDs; and 3) measure the impact of the teaching module.<h4>Methods</h4>Using a quality improvement in health-care framework, a survey exploring the barriers to AED use was sent to 139 elementary schools. ...[more]

PMID: 37969560

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Project description:Background Treatment with an automated external defibrillator (AED) improves outcome in out-of-hospital cardiac arrest (OHCA). Audiovisual feedback from an AED may assist bystanders achieve higher quality cardiopulmonary resuscitation. However, the association between audiovisual feedback and clinical outcomes is not well assessed in real-life OHCA. The aim of this study was to assess the association between audiovisual feedback from an AED used in bystander resuscitation with rates of return of spontaneous circulation (ROSC) and 30-day survival in a real-life cohort of patients with OHCA. Methods and Results We included 325 patients treated with bystander AED use before arrival of emergency medical services during 2016 to 2019 from the Capital Region of Denmark. Patients were divided into a "feedback" and a "nonfeedback" group, depending on presence of audiovisual feedback from the AED. Audiovisual feedback was defined as voice prompts with continuous feedback to ongoing resuscitation. Rates of ROSC upon hospital admission and 30-day survival were assessed, and univariate and multivariable models were applied to decide the association to audiovisual feedback. Multivariable models were adjusted for sex, age, primary heart rhythm, and location of OHCA. A total of 155 (48%) patients had a bystander AED applied with audiovisual feedback and 170 (52%) without audiovisual feedback. A lower rate of ROSC was found in the feedback group compared with the nonfeedback group (33% [n=51] versus 45% [n=76]; P=0.03). No association was observed between AV feedback and 30-day survival (feedback=27% [n=42] and nonfeedback=31% [n=53]; P=0.49). In the unadjusted logistic regression model, audiovisual feedback was associated with a decreased chance of ROSC (odds ratio, 0.61; 95% CI, 0.38-0.95; P=0.03), which remained significant after adjusted analysis (odds ratio, 0.53; 95% CI, 0.29-0.97; P=0.04), whereas we found no significant association between audiovisual feedback and 30-day survival in the unadjusted and adjusted analyses. Conclusions Audiovisual feedback from an AED used by bystanders was associated with a lower chance of ROSC at hospital admission, but we found no significant difference in 30-day survival. Focus on early and correct bystander cardiopulmonary resuscitation and AED use remain key for OHCA survival.

Project description:BackgroundSurvival following out-of-hospital cardiac arrest (OHCA) with shockable rhythms can be improved with early defibrillation. Although shockable OHCA accounts for only ≈25% of overall arrests, ≈60% of public OHCAs are shockable, offering the possibility of restoring thousands of individuals to full recovery with early defibrillation by bystanders. We sought to determine the association of bystander automated external defibrillator use with survival and functional outcomes in shockable observed public OHCA.MethodsFrom 2011 to 2015, the Resuscitation Outcomes Consortium prospectively collected detailed information on all cardiac arrests at 9 regional centers. The exposures were shock administration by a bystander-applied automated external defibrillator in comparison with initial defibrillation by emergency medical services. The primary outcome measure was discharge with normal or near-normal (favorable) functional status defined as a modified Rankin Score ≤2. Survival to hospital discharge was the secondary outcome measure.ResultsAmong 49 555 OHCAs, 4115 (8.3%) observed public OHCAs were analyzed, of which 2500 (60.8%) were shockable. A bystander shock was applied in 18.8% of the shockable arrests. Patients shocked by a bystander were significantly more likely to survive to discharge (66.5% versus 43.0%) and be discharged with favorable functional outcome (57.1% versus 32.7%) than patients initially shocked by emergency medical services. After adjusting for known predictors of outcome, the odds ratio associated with a bystander shock was 2.62 (95% confidence interval, 2.07-3.31) for survival to hospital discharge and 2.73 (95% confidence interval, 2.17-3.44) for discharge with favorable functional outcome. The benefit of bystander shock increased progressively as emergency medical services response time became longer.ConclusionsBystander automated external defibrillator use before emergency medical services arrival in shockable observed public OHCA was associated with better survival and functional outcomes. Continued emphasis on public automated external defibrillator utilization programs may further improve outcomes of OHCA.

Dataset Information

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study.

Background

Methods

Results

Conclusions

Publications

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study.

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