EARLY ACCESS TO DEFIBRILLATION FOR VICTIMS OF OOH-CA

在每年30万例心脏骤停死亡中，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，访问911系统，并进行心肺复苏。现有的紧急复苏方法对于具有除颤能力的训练有素的响应者到达心脏骤停的人的位置具有固有的时间延迟。公共访问除颤（PAD），其中包括在社区更广泛地放置自动体外除颤器（AED），并培训外行人使用它们，是改善在公共场所晕倒的心脏骤停受害者的紧急治疗的一种策略。众所周知，当AED由受过训练的紧急医疗服务人员和其他受过训练的人员（如航空公司乘务员）使用时，该设备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以下假设：与接受标准救生技术（识别心脏骤停、911接入和心肺复苏）培训的社区志愿者相比，接受过院外心脏骤停患者使用自动体外除颤器培训的志愿者出院存活率将显著提高。其他目标包括评估神经系统的结果，生活质量和公共访问除颤的成本效益。这项研究是一项多中心对照社区研究，在1000个社区单位进行，如机场，住宅公寓，购物中心，老年人中心，封闭社区，办公楼和体育场馆。参与社区的志愿者将接受培训，以识别心脏骤停，访问911系统，并进行心肺复苏。一半的社区单位也将在显眼的位置放置AED，这些位置的志愿者将接受使用这些设备的培训。该研究是通过20-25个现场分包商，协调中心和国家心肺和血液研究所（NHLBI）之间的合作开发和进行的。 该项目作为协调中心。

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.