Academic journal article American Journal of Pharmaceutical Education

Pharmacy Students' Retention of Knowledge and Skills Following Training in Automated External Defibrillator Use

Academic journal article American Journal of Pharmaceutical Education

Pharmacy Students' Retention of Knowledge and Skills Following Training in Automated External Defibrillator Use

Article excerpt

INTRODUCTION

Approximately 295,000 Americans die annually from sudden cardiac arrest and the majority of these cases are caused by ventricular tachycardia or fibrillation. (1) Early defibrillation of sudden cardiac arrest improves the patient's chance of survival. If not performed, the victim's chance for survival decreases approximately 10% for every 1 minute of delay. (1-4) Despite access to certified training programs and increased availability of automated external defibrillators (AED) in public places, the incidence of bystander cardiopulmonary resuscitation (CPR) and defibrillation for victims of out-of-hospital cardiac arrest is low. (5,6) Unfortunately, almost 80% of sudden cardiac arrest occur in residential settings where an automated external defibrillator may not be available and timely emergency medical services can be challenging. (7) One automated external defibrillator has received approval for over-the-counter sales in the United States (HeartStart OnSite Defibrillator, Philips Medical Systems, Andover, MA) and is intended for placement in the homes of patients at high risk for sudden cardiac arrest. However, there are no training requirements prior to purchasing this device.

Pharmacists are in a unique position to provide automated external defibrillator counseling of non-medical laypersons to ensure proper and safe use. Pharmacists routinely educate patients on the use and maintenance of common over-the-counter medical devices like blood glucose meters and blood pressure monitors. Since automated external defibrillators are now available for purchase, a pharmacist who sells them for home use should be competent in the knowledge and skills necessary to provide support and training of patients and family members. As automated external defibrillators become more available to consumers, and should the 2010 International Liaison Committee on Resuscitation (ILCOR) continue to place a strong emphasis on early access to defibrillation, (8) pharmacists will be positioned to act as sudden cardiac arrest public service practitioners. The pharmacy profession should recognize that counseling laypersons purchasing an automated external defibrillator is a professional responsibility and this education provided by pharmacists reinforces previous training the layperson has received from other sources. The first step to meeting this public health obligation is pharmacist training and education, which begins by incorporating this topic into the pharmacy curriculum.

Requiring doctor of pharmacy (PharmD) students to become competent in the use and maintenance of automated external defibrillators is supported by the Center for Advancement of Pharmacy Education (CAPE) educational outcomes. These standards recommend that pharmacy students become proficient in educating patients and caregivers on the proper use of medical goods and devices. (9) This includes demonstrating the use of medical devices to ensure effective home use and communicating important maintenance and storage information. The 2007 Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines also address the role of pharmacy students in promoting health improvement and wellness in cooperation with patients and at-risk populations. (10) To ensure the availability of effective public health services, these standards recommend that students maintain professional competency by identifying emerging products and services that may affect the efficacy of disease prevention services in order to update existing services or implement new ones. We consider the ability to deliver a defibrillation shock and knowing how to care for an automated external defibrillator to be an emerging public health skill for pharmacy students and pharmacists that will ultimately improve the health and wellness of patients at risk for sudden cardiac arrest.

Multiple studies have demonstrated that primary school, (11) high school, (12) medical, (13,14) and nursing students (15,16) can be trained to successfully deliver a shock to a patient/subject using an automated external defibrillator. …

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