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Barriers and enablers to public access defibrillation - an international RAND-UCLA consensus study.
K C Thies1, C Metelmann2,3, B Metelmann2
1Department of Anaesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, University of Bielefeld, EvKB University Hospital of Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33167, Bielefeld, Germany. Karl.Thies@evkb.de.
Summary
Improving public access defibrillation (PAD) requires addressing AED availability, training, and integration. Innovative deployment models and coordinated policies are crucial for enhancing survival rates after out-of-hospital cardiac arrest.
Area of Science:
- Emergency Medicine
- Public Health
- Cardiology
Background:
- Immediate cardiopulmonary resuscitation and early defibrillation are critical for survival after out-of-hospital cardiac arrest (OHCA).
- Public access defibrillation (PAD) implementation faces challenges in automated external defibrillator (AED) availability, integration, and usage.
- This study aimed to identify and prioritize barriers and enablers for PAD implementation and explore novel deployment models.
Purpose of the Study:
- To identify and prioritize barriers and enablers to public access defibrillation (PAD) implementation.
- To highlight emerging deployment models for automated external defibrillator (AED) use in out-of-hospital cardiac arrest (OHCA) scenarios.
- To inform future research and policy development for improving PAD effectiveness.
Main Methods:
- A structured RAND-UCLA Appropriateness Method consensus study was conducted with 46 international experts.
- Participants identified barriers and enablers to PAD, categorized into four thematic fields.
- Nine consensus statements were formulated and rated using a 9-point Likert scale to achieve strong consensus.
Main Results:
- Strong consensus was reached on nine key statements regarding PAD barriers and enablers.
- Identified barriers include limited 24/7 AED access, poor residential coverage, lack of real-time registries, insufficient training, legal concerns, and integration issues.
- Enablers include mandatory AED registration, community training, legal protection, equipping first responders, and innovative deployment strategies like drone use.
Conclusions:
- Coordinated policy, robust AED registries, widespread training, and multi-tier response models are essential for effective PAD implementation.
- The study provides a prioritized agenda for future system development in public access defibrillation.
- Addressing identified barriers and leveraging innovative strategies can significantly improve OHCA survival rates.
Keywords:
Automated external defibrillatorsBystander interventionCardiopulmonary resuscitationDefibrillationEmergency medical servicesOut-of-hospital cardiac arrestPublic access defibrillationSurvival rateMore Related Videos
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