Dispatcher assistance and automated external defibrillator performance among elders

Area of Science:

• Emergency medicine
• Cardiology
• Gerontology

Background:

• Automated external defibrillators (AEDs) can improve survival rates for out-of-hospital cardiac arrest.
• The role of emergency dispatchers in guiding laypersons to use AEDs is not well-established.
• Older adults may benefit from dispatcher assistance during AED deployment.

Purpose of the Study:

• To investigate if dispatcher telephone assistance impacts AED skill performance in older adults during a simulated ventricular fibrillation (VF) cardiac arrest.
• To determine if dispatcher assistance increases the likelihood of successful shock delivery.
• To assess the effect of dispatcher assistance on the time to shock delivery.

Main Methods:

• 150 community-dwelling older adults (aged 58-84) with prior AED training were recruited.
• Participants were randomized to perform AED operation with or without dispatcher assistance during a simulated VF cardiac arrest.
• Success rates of shock delivery and time intervals from collapse to shock were compared between groups.

Main Results:

• Participants receiving dispatcher assistance were significantly more likely to correctly deliver a shock (91% vs. 68%, p=0.001).
• However, those with dispatcher assistance required a longer time to deliver the shock (median 193 seconds vs. 148 seconds, p=0.001).

Conclusions:

• Dispatcher assistance may enhance the ability of older, previously trained laypersons to successfully deliver a shock using an AED during a VF cardiac arrest.
• This assistance may increase the proportion of successful defibrillations, despite a potential increase in time to therapy.