Powell Judy, Van Ottingham Lois, Schron Eleanor
Clinical Trial Center, University of Washington, Seattle, Wash., USA.
J Cardiovasc Nurs. 2004 Nov-Dec;19(6):384-9. doi: 10.1097/00005082-200411000-00009.
The Public Access Defibrillation (PAD) trial was a prospective, randomized, controlled study designed to compare the number of persons surviving to hospital discharge after experiencing an out-of-hospital cardiac arrest (OOH-CA) among "community units" randomized to receive cardiopulmonary resuscitation (CPR) only or CPR plus an automated external defibrillator (AED). In 24 centers across the United States and Canada, 993 community units, composed of 1260 individual facilities, trained more than 19,000 layperson responders in CPR-only or CPR+AED. Survival to hospital discharge in the CPR+AED arm was double that of the CPR-only arm (30 vs 15, P = .03; RR = 2.0, 95% CI [1.07-3.77]). Intense focus on facility infrastructure, including responder recruitment and training, communication, evaluation, and oversight, was necessary for implementing the emergency response systems for the trial. Use of an AED within this structured response system can increase the number of survivors to hospital discharge after OOH-CA. Trained nonmedical responders can use AEDs safely and effectively.
公众可获取除颤（PAD）试验是一项前瞻性、随机对照研究，旨在比较随机分配接受单纯心肺复苏（CPR）或CPR加自动体外除颤器（AED）的“社区单元”中，院外心脏骤停（OOH-CA）后存活至出院的人数。在美国和加拿大的24个中心，993个由1260个独立设施组成的社区单元，对超过19000名仅接受CPR或CPR+AED培训的非专业急救人员进行了培训。CPR+AED组的出院存活率是单纯CPR组的两倍（30%对15%，P = 0.03；RR = 2.0，95%CI [1.07 - 3.77]）。对于实施该试验的应急响应系统而言，高度关注设施基础设施，包括急救人员的招募与培训、通信、评估和监督是必要的。在这个结构化响应系统中使用AED可增加OOH-CA后存活至出院的人数。经过培训的非医疗急救人员可以安全有效地使用AED。
