An evaluation of the Public Access Defibrillation (PAD) Demonstration

6.5 Appropriateness of response procedures in organisations

Page last updated: August 2008

The appropriateness of response procedures was investigated including notification of the local ambulance service of the presence of an AED, the development of on-site emergency plans and display of the PAD action-plan.

6.5.1 Notification of ambulance service
6.5.2 Action plans
6.5.3 Use of the AED

6.5.1 Notification of ambulance service

Half (53%) of managers interviewed knew that the local ambulance service was aware that an AED had been installed at the organisation. Of the remainder, many did not know if the ambulance service was aware (36%) and only one in ten (11%) knew that they had not been informed.

6.5.2 Action plans

All staff (100%) were aware of the location of the AED(s) in their organisation, most organisations had the PAD action-plan located close by and this had been seen by staff (Figure 16):
  • Nine in ten (91%) organisations had a PAD action-plan displayed close to the AED
  • Four in five staff (81%) reported that they had seen this action-plan (19% of staff had not) and
  • When asked to rate the information presented in the PAD action-plan, three in four (75%) staff rated it as excellent or very good. No staff rated the action-plan fair or poor.
The installation of the AED did not happen in isolation with the majority of organisations developing specific plans. Seven in ten (70%) managers indicated that their organisation had an on-site emergency plan for this type of situation. Almost nine in ten (86%) staff agreed (strongly agreed and agreed) that 'Clear procedures and plan of action are in place if there is an emergency'. A minority (7% or 4 staff) disagreed that the organisation has clear procedures and a plan of action.

All trained staff were aware of the location of the AED and most organisations had the PAD action plan displayed close to the AED. On-site emergency plans had been developed in seven in ten organisations. Top of page

Figure 16: Display of action and emergency plan on-site

Q19. Do you have the Public Access Defibrillation action-plan displayed close to the AED?
Q20. Is there an on-site emergency plan for this type of situation?

Figure 16: Display of action and emergency plan on-site

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6.5.3 Use of the AED

Four organisations indicated that an AED received under the Pad Demonstration had been activated:
  • One activation saved the life of the patient
  • One patient had a non-shockable rhythm and
  • Two patients died on-site.
Only one of the four activations had been carried out by trained staff. The other three activations had been carried out by lay persons (it is not known whether these lay persons were medically trained bystanders or not).

All four host organisations had received a de-brief from St John after the activation event. Three out of four organisations had the event data successfully downloaded.

One manager had personal experience with an AED activation. While the patient died on-site, the respondent was positive about the way in which they were able to provide assistance: the training received helped them handle the situation; they found it easy to use the AED and followed the step by step verbal instructions from the AED; they found the de-brief from St John useful; and importantly they were pleased to have been able to assist and it did not deter them from helping in the future. The one aspect to which they disagreed was that members of the public provided support.

Few activations of the AED were reported by host organisations.