Abstract
BackgroundStudent training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools.MethodsA qualitative study based on semi-structured individual interviews and focus groups with a total of 25 participants, nine school leaders, and 16 teachers at eight different secondary schools in Denmark (2012–2013). Thematic analysis was used to identify regular patterns of meaning using the technology acceptance model and focusing on the concepts of perceived usefulness and perceived ease of use.ResultsSchool leaders and teachers are concerned that automated external defibrillators are potentially dangerous, overly technical, and difficult to use, which was related to their limited familiarity with them. They were ambiguous about whether or not students are the right target group or which grade is suitable for defibrillator training. They were also ambiguous about deployment of defibrillators at schools. Those only accounting for the risk of students, considering their schools to be small, and that time for professional help was limited, found the relevance to be low. Due to safety concerns, some recommended that defibrillators at schools should be inaccessible to students. They lacked knowledge about how they work and are operated, and about the defibrillators already placed at their campuses (e.g., how to access them). Prior training and even a little knowledge about defibrillators were crucial to their perception of student training but not for their considerations on the relevance of their placement at schools.ConclusionsIt is crucial for implementation of automated external defibrillators in schools to inform staff about how they work and are operated and that students are an appropriate target group for defibrillator training. Furthermore, it is important to provide schools with a basis for decision making about when to install defibrillators, and to ensure that school staff and students are informed about their placement.
Highlights
Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest
Zinckernagel et al BMC Emergency Medicine (2017) 17:3 (Continued from previous page). It is crucial for implementation of automated external defibrillators in schools to inform staff about how they work and are operated and that students are an appropriate target group for defibrillator training
School leaders and teachers are ambiguous about whether or not secondary school students is an appropriate target group and do not know what grade is suitable for automated external defibrillator (AED) training
Summary
Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. In Europe, the survival rate following OHCA is only ≈ 10% and costs 350,000 lives each year [2] It has been known for more than two decades that bystander cardiopulmonary resuscitation (CPR) before the arrival of emergency medical services (EMS) increases survival rates 2–4 times [3, 4]. Training students in CPR and AED use has become mandatory or at least recommended in several countries [2, 7, 10], but even in countries like Denmark that have mandatory resuscitation training in schools, low implementation rates have been observed, for AED training [11, 12]. Previous studies have identified barriers to the implementation of CPR training in school such as perceived need for extensive CPR instruction skills, need for training material, excessive consumption of teaching time, and excessive costs [11,12,13,14,15,16,17]
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