Kaye W, Mancini M E, Richards N
Department of Surgery, Brown University, Miriam Hospital, Providence, RI 02906, USA.
Resuscitation. 1995 Oct;30(2):151-6. doi: 10.1016/0300-9572(95)00881-s.
First-responder automated external defibrillation (AED) in the hospital is consistent with the American Heart Association's (AHA) early defibrillation standard or care. With trained personnel and automated external defibrillators immediately available, early defibrillation should have a greater impact on survival than early cardiopulmonary resuscitation (CPR). Therefore, in our hospitals we modified basic life support to include automated external defibrillation (BLS-AED) for all personnel who are expected to respond to a cardiac arrest, with rapid defibrillation taking priority over CPR. We describe how we organized and implemented this hospital-wide first-responder BLS-AED program. Planning the process includes gaining support from key leaders who are responsible for resuscitation practice, and identifying the target audience of the training program. Hospital unit needs for AED or conventional defibrillation and equipment must be identified, the training program developed, and existing policies and procedures modified. Several barriers to implementation may exist. Education about the efficacy and safety of AED and experience once the BLS-AED program is in place can overcome attitudes and bias. Concerns about the cost of equipment and training must be addressed. Program evaluation may include patient issues such as measuring the time to the first defibrillation and patient outcome; as well as training and retention issues.
医院内急救人员使用自动体外除颤器（AED）符合美国心脏协会（AHA）的早期除颤标准或护理要求。有了经过培训的人员和随时可用的自动体外除颤器，早期除颤对生存率的影响应该比早期心肺复苏（CPR）更大。因此，在我们医院，我们对基本生命支持进行了改进，为所有预期对心脏骤停做出反应的人员配备自动体外除颤器（BLS-AED），快速除颤优先于心肺复苏。我们描述了我们如何组织和实施这个全院范围的急救人员BLS-AED项目。规划过程包括获得负责复苏实践的关键领导者的支持，并确定培训项目的目标受众。必须确定医院各科室对AED或传统除颤及设备的需求，制定培训项目，并修改现有政策和程序。实施过程中可能存在一些障碍。关于AED功效和安全性的教育以及BLS-AED项目实施后的经验可以克服人们的态度和偏见。必须解决对设备和培训成本的担忧。项目评估可能包括患者相关问题，如测量首次除颤时间和患者预后；以及培训和人员留存问题。
