Implementation of community-based public access defibrillation in the PAD trial

Lynne D. Richardson, Mary D. Gunnels, William J. Groh, Mary Ann Peberdy, Sarah Pennington, Ilene Wilets, Venard Campbell, Lois Van Ottingham, Mary Ann McBurnie, Joseph P. Ornato, Myron Weisfeldt, Michael R. Sayre, Barbara Riegel, Krishnaswami Vijayaraghavan, Thomas Mattioni, Claudia Williams, Andy R. Anton, Constance D. Jones, Stephen Yahn, Dennis RabelRobert E. O'Connor, Patricia McGraw, Melissa Bollinger, Ross E. Megargel, Alfred P. Hallstrom, H. Leon Greene, Judy Powell, Alice Birnbaum, Robert B. Ledingham, Richard Moore, Mary Morris, Margit Scholz, Art Kerr, Costas T. Lambrew, David C. Goff, Laurence McCullough, Louis Gonzales, Henry A. Feldman, Allan Braslow, Richard A. Craven, Lois A. Bosken, Patricia Burke, Judith Paulsen, Gary Newton, Graham Nichol, George Wells, Ella Huszti, Jennifer Rokosh, Debbie Morris, Karen Kuntz, Brian D. Mahoney, Rachel Knudson-Ballard, George Vasquez, William J. Groh, Deb Cordes, Susan J. Bondurant, Max Harry Weil, N. Clay Mann, Brent Shaum, Kimberlee Brown, Kammy Jacobsen, Ruchir Sehra, Tom P. Aufderheide, Ronald G. Pirrallo, Craig J. Conrad, David J. Kitscha, Christopher W. Sparks, Chris Von Briesen, Kimberly A. Deja, Marge M. Lestarge, Richard W. Janisch, Sandra S. Schmidt, Lisa Parmenter, Laura Grabowski, Stephen Ehrlich, Bruce Haynes, Linda Asbury, Margaret Amaya, Jennifer Holohan, Frederick Ehlert, Christopher Freyberg, Neal Richmond, Christopher Shields, Eleanor B. Schron, Jerome Fleg, Michael J. Domanski, Michael Proschan, Yves Rosenberg, Lisa O'Neill, Denise Simons-Morton, Marcel E. Salive, Mohamud Daya, Mary D. Gunnels, Jerris R. Hedges, Jonathan Jui, Terri Schmidt, Lynn Wittwer, Heather Brooks, Christopher Burke, Denise Griffiths, Michael Osur, Brian MacGavin, Britta Myrin, Richard O. Cummins, Alidene Doherty, Sue Thompson, Sue Wood, Jim Christenson, Sarah Pennington, Allan Holmes, Heather Payne, Roland Webb, Nadia Douglas, Patricia Lawson, Mark C. Henry, Scott Johnson, Henry Thode, Edward R. Stapleton, David B. Reed, Lawrence H. Brown, Lisa M. Evans, P. Jacob Varghese, Ray Lucas, Thomas E. Terndrup, Shannon Stephens, Sarah Nafziger, Janyce Sanford, David Feeny, Andrew Travers, Adrian Panylyk, Kathryn Irwin, Brenda Heisz, Lance B. Becker, Anne Barry, Ellen Demertsidis, Jonathan Van Zile, Christine Grimmelsman, Laura Nolting, Vince N. Mosesso, Brian K. Slater, Venard J. Campbell, David Hostler, Jerry Overton, Kelly Schaffer, Robert Zalenski, Scott Compton, Robert Dunne, Robert Swor, Robert Welch, LynnMarie Mango, Kristen Bilicki

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: The Public Access Defibrillation (PAD) Trial was a randomized, controlled trial designed to measure survival to hospital discharge following out-of-hospital cardiac arrest (OOH-CA) in community facilities trained and equipped to provide PAD, compared with community facilities trained to provide cardiopulmonary resuscitation (CPR) without any capacity for defibrillation. Objectives: To report the implementation of community-based lay responder emergency response programs in 1,260 participating facilities recruited for the PAD Trial in the United States and Canada. Methods: This was a descriptive study of the characteristics of participating facilities, volunteers, and automated external defibrillator (AED) placements compiled by the PAD Trial, and a qualitative study of factors that facilitated or impeded implementation of emergency lay responder programs using focus groups of PAD Trial site coordinators. Results: The PAD Trial enrolled 1,260 community facilities (14.8% residential), with 20,400 lay volunteers (mean ± standard deviation = 13.4 ± 10.7 per facility) trained to respond to OOH-CA. The 598 locations randomized to receive AEDs required 2.7 ± 1.8 AEDs per facility. Volunteer attrition was high, 36% after two years. Barriers to recruitment and implementation included identification of appropriate "at-risk" facilities, lack of interest or fear of litigation by a facility key decision maker, lack of motivated potential volunteer responders, training and retraining resource requirements, and lack of an existing communication/response infrastructure. Conclusions: These data indicate that implementation of community-based lay responder programs is feasible in many types of facilities, although these programs require substantial resources and commitment, and many barriers to implementation of effective PAD programs exist.

Original languageEnglish (US)
Pages (from-to)688-697
Number of pages10
JournalAcademic Emergency Medicine
Issue number8
StatePublished - Aug 2005

Bibliographical note

Funding Information:
Supported by Contract #N01–HC–95177 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; American Heart Association, Dallas, TX; Medtronic, Incorporated, Minneapolis, MN; Guidant Foundation, Indianapolis, IN; Cardiac Science/SurVivaLink, Incorporated, Minneapolis, MN; Medtronic Physio-Control Corporation, Redmond, WA; Philips Medical Systems/Heartstream, Seattle, WA; and Laerdal Medical Corporation, Wappingers Falls, NY.


  • Automated external defibrillators
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Defibrillation
  • Out-of-hospital cardiac arrest
  • Public access defibrillation


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