Posted on 09/15/2011

Widespread public education campaigns needed

AMSTERDAM—Most laypersons are unfamiliar with automated external defibrillators (AEDs) and would be unwilling to use them to help victims of sudden cardiac arrest (SCA), according to Patrick Schober, MD, PhD, and colleagues at the VU University Medical Center in Amsterdam, the Netherlands.

Public accessible AEDs are increasingly made available in highly frequented places, allowing coincidental bystanders to defibrillate with minimal delay if necessary. Although the public, as the largest and most readily available group of potential rescuers, is assigned a key role in this concept of "public" access defibrillation, it is unknown whether bystanders are sufficiently prepared.

To find out, investigators conducted interviews at the Central Railway Station of Amsterdam, a highly frequented and AED equipped public place. An analysis of surveys from 1,018 participants from 38 nations revealed a considerable lack of knowledge among the public.

When asked what should be done as quickly as possible if someone has a suspected cardiac arrest, the most frequently given answer was “call for help” (67%), followed by “chest compressions” (20%). Only 6% of participants spontaneously mentioned defibrillation or AED in any way, indicating that they would keep defibrillation or AED use in mind if confronted with a cardiac arrest in the future.

More than half of participants (53%) were unable to recognize an AED; less than half (47%) would be willing to use one. Overall, only a minority of individuals have sufficient knowledge and would be willing to use an AED.

Not surprisingly, healthcare professionals and first responders were more knowledgeable than laypersons. Yet one-fourth of these professionals were unfamiliar with AEDs and would be reluctant to use them.

The most frequently concerns cited by study participants were:

  • Not knowing how the AED works
  • Fear of hurting someone
  • Liabilty concerns based on the belief that use of AEDs is restricted to professionally trained rescuers.

The researchers conclude that wide-scale public information campaigns are an important next step to improve the lifesaving potential of public access defibrillation.

In a related editorial, Joseph P. Ornato, MD, Virginia Commonwealth University/Medical College of Virginia, Richmond, VA, says the next logical step would be to conduct a similar survey in the United States and Canada. If results are consistent with findings in the Netherlands, he recommends developing, implementing and tracking a massive public education campaign that includes brief (e.g., one-minute) “just-in-time” training in public locations such as airports.

 

SOURCES:

Schober P, van Dehn FB, Bierens JJ, Loer SA, Schwarte LA. Public access defibrillation: time to access the public. Ann Emerg Med. 2011 Sep;58(3):240-7. Epub 2011 Feb 3.

Ornato, JP. Getting lay rescuers to use public access defibrillators. Ann Emerg Med. 2011;58:248-249.

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