The acquisition and maintenance of defibrillation skills by lay first responders

Non-traditional and lay first responders increasingly are being trained in the skill of defibrillation. With simplification of new devices, there is a need to determine optimal first responder selection and training and maintenance of this important skill. These issues are of prime importance for the St John Ambulance Australia Operations Branch which already has a substantial first response defibrillation programme.

We trained 12 trainers (3 h and 30 min), who subsequently instructed 41 further first responders (2 h and 30 min), a total group with a broad range of pre-existing experience and skill level, in the use of an automated external defibrillator (AED). Acquisition and maintenance of the AED skill was determined by four criteria at three monthly intervals.

St John first responders with higher qualification levels were more likely to acquire the skill of defibrillation successfully (r=0.37, P<0.05). However, once acquired, the skill was easily maintained by virtually all (98%) members. A positive correlation was noted between the overall score achieved at the 6-month re-assessment and the number of times members had taken an AED 'on duty' (r=0.31, P<0.05).

For St John first responders proficient in cardiopulmonary resuscitation (CPR), the skill of defibrillation with an AED is readily acquired and maintained. While less experienced members may be less likely to acquire the skill initially, once acquired the skill is equally maintained by all, provided ongoing 'on duty' exposure is available.