Automated external defibrillators: implications for training qualified ambulance staff.

Abstract

To investigate the performance of basic trained ambulance personnel using an automated external defibrillator (AED) after a short training program. One hundred ninety ambulance attendants working in London received six and one-half hours training in the use of an AED, with written feedback and continuing education regarding performance after training. Performance was assessed over a period of 15 months by analysis of report forms and ECG/audible cassette tapes from the patients who were treated. Staff were able to operate the defibrillator correctly in 96% of cases and followed the protocol sequence taught in 34% of cases. The median time taken to activate the defibrillator following arrival of the ambulance at the scene of cardiac arrest was four minutes (range, one to 13 minutes). In 32% of cases, patients were intubated erroneously or moved to the ambulance before the AED was attached. The short course with continuing education was sufficient to train staff in AED operation, but errors in protocol compliance occurred throughout the trial.