EARLY ACCESS TO DEFIBRILLATION FOR VICTIMS OF OOH-CA

在每年因心脏骤停而死亡的30万人中，约有四分之一发生在家庭以外的公共场所。减少这些死亡的传统策略包括培训非专业人员识别心脏骤停，使用911系统并进行心肺复苏。现有的紧急复苏方法对于训练有素的具有除颤能力的响应者到达心脏骤停患者的位置有固有的时间延迟。公共场所除颤（PAD）包括在社区更广泛地放置自动体外除颤器（aed），并对非专业人员进行使用培训，这是改善对在公共场所晕倒的心脏骤停患者的紧急治疗的一种策略。如果训练有素的紧急医疗服务人员和其他训练有素的人员（如航空公司空乘人员）使用aed，它可以有效地帮助心脏骤停的受害者。本研究项目的主要目的是检验这样一种假设，即与接受过标准救生技术（识别心脏骤停、911呼叫和心肺复苏）培训的社区志愿者相比，接受过使用自动体外除颤器培训的志愿者在医院外心脏骤停患者出院时的存活率将显著提高。其他目标包括评估神经预后、生活质量和公共通道除颤的成本效益。本研究是一项多中心对照社区研究，在机场、住宅公寓、购物中心、老年中心、封闭式社区、办公大楼、体育场馆等1000个社区单元中进行。参与社区的志愿者将接受培训，以识别心脏骤停，使用911系统，并进行心肺复苏。一半的社区单位还将在显眼的地方放置除颤器，这些地方的志愿者将接受使用这些设备的培训。这项研究是通过20-25个现场分包商、一个协调中心和国家心肺血液研究所（NHLBI）的合作开发和实施的。这个项目作为协调中心。

About one-fourth of the 300,000 annual deaths from sudden cardiac arrest take place outside of the home in public places. Traditional strategies for reducing these deaths have involved training lay persons to recognize cardiac arrest, to access the 911 system, and to perform cardiopulmonary resuscitation. Existing methods of emergency resuscitation have inherent time delays for a trained responder with defibrillation capability to get to the location of a person in cardiac arrest. Public access defibrillation (PAD), which involves placing automatic external defibrillators (AEDs) more widely in the community and training lay persons in their use, is one strategy for improving emergency treatment of victims of sudden cardiac arrest who collapse in public places. AEDs are known to work effectively to help victims of sudden cardiac arrest when the devices are used by trained emergency medical services personnel and other trained persons such as airline flight attendants. The primary objective of this research program is to examine the hypothesis that volunteers trained in the use of automatic external defibrillators for out-of-hospital cardiac arrest victims will significantly increase survival to hospital discharge, compared with community volunteers trained in standard life-saving techniques (recognition of cardiac arrest, 911 access and cardiopulmonary resuscitation). Other objectives include evaluation of neurological outcomes, quality of life, and cost effectiveness of public access defibrillation. This research is a multicenter controlled community study conducted in 1000 community units such as airports, residential apartments, shopping centers, senior centers, gated communities, office buildings, and sports venues. Volunteers in participating communities will be trained to recognize cardiac arrest, to access the 911 system, and to perform cardiopulmonary resuscitation. Half of the community units will also have AEDs placed in conspicuous locations, and the volunteers in those locations will be trained to use the devices. The research study is developed and conducted through collaboration among 20-25 field site subcontractors, a coordinating center, and the National Heart Lung and Blood Institute (NHLBI). This project serves as the coordinating center.