This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gundry, J. W. Articles by Bardy, G. H. Search for Related Content PubMed PubMed Citation Articles by Gundry, J. W. Articles by Bardy, G. H. Pubmed/NCBI databases Medline Plus Health Information Children's Page Related Collections Health policy and outcome research CPR and emergency cardiac care Arrhythmias, clinical electrophysiology, drugs

(Circulation. 1999;100:1703-1707.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

Comparison of Naive Sixth-Grade Children With Trained Professionals in the Use of an Automated External Defibrillator

John W. Gundry, MD; Keith A. Comess, MD; Frances A. DeRook, MD; Dawn Jorgenson, PhD; Gust H. Bardy, MD

From the Division of Cardiology, Department of Medicine, University of Washington, Seattle, Wash.

Correspondence to Gust H. Bardy, MD, Box 356422, University of Washington Medical Center, Seattle, WA 98195-6422. E-mail gbardy{at}u.washington.edu

Background—Survival after out-of-hospital cardiac arrest (OHCA) is strongly influenced by time to defibrillation. Wider availability of automated external defibrillators (AEDs) may decrease response times but only with increased lay use. Consequently, this study endeavored to improve our understanding of AED use in naive users by measuring times to shock and appropriateness of pad location. We chose sixth-grade students to simulate an extreme circumstance of unfamiliarity with the problem of OHCA and defibrillation. The children's AED use was then compared with that of professionals.

Methods and Results—With the use of a mock cardiac arrest scenario, AED use by 15 children was compared with that of 22 emergency medical technicians (EMTs) or paramedics. The primary end point was time from entry onto the cardiac arrest scene to delivery of the shock into simulated ventricular fibrillation. The secondary end point was appropriateness of pad placement. All subject performances were videotaped to assess safety of use and compliance with AED prompts to remain clear of the mannequin during shock delivery. Mean time to defibrillation was 90±14 seconds (range, 69 to 111 seconds) for the children and 67±10 seconds (range, 50 to 87 seconds) for the EMTs/paramedics (P<0.0001). Electrode pad placement was appropriate for all subjects. All remained clear of the "patient" during shock delivery.

Conclusions—During mock cardiac arrest, the speed of AED use by untrained children is only modestly slower than that of professionals. The difference between the groups is surprisingly small, considering the naïveté of the children as untutored first-time users. These findings suggest that widespread use of AEDs will require only modest training.

Key Words: defibrillation • fibrillation • death, sudden • cardiopulmonary resuscitation