Protocol Adherence of Community Sites in the Public Access Defibrillation Trial

OBJECTIVES: The purpose of this study is to identify patterns and characteristics associated with site adherence to the Public Access Defibrillation (PAD) Trial protocol. METHODS: The PAD Trial recruited community sites to evaluate the impact on survival from out-of-hospital cardiac arrest (OOH-CA) when automated external defibrillators (AEDs) are added to a volunteer-based lay OOH-CA response team. Sites were grouped into either residential or public (hotel/convention, shopping, community center, entertainment, participant recreation, transit, office, industrial and other). Volunteers at each site were trained to perform either CPR or CPR + AED skills according to site randomization assignments. Four types of site non-adherence have been defined: crossover (from assigned treatment arm), administrative drop (location closed or withdrew, unrelated to randomization), withdrawal (site decided not to participate in the trial), and never trained (unable to complete training). Statistical analysis used chi-square test. RESULTS: A total of 1304 entities participated, 211 did not adhere to the protocol, with 29 (2%) crossovers 45 (3%) administrative drops, 50 (4%) withdrawals, and 87 (7%) never trained. Adherence ranged from 73% (industrial, residential) to 97% (hotel/convention). When compared with public, residential sites had a higher percentage that dropped out (12% vs. 2%) or were administratively dropped. (9% vs. 2%) (p