Layperson’s performance on an unconversant type of AED device: A prospective crossover simulation experimental study

doi:10.5847/wjem.j.1920-8642.2022.024

Abstract

Abstract:

BACKGROUND: Diverse models of automated external defibrillators (AEDs) possess distinctive features. This study aimed to investigate whether laypersons trained with one type of AED could intelligently use another initial contact type of AED with varying features.
METHODS: This was a prospective crossover simulation experimental study conducted among college students. Subjects were randomly trained with either AED1 (AED1 group) or AED2 (AED2 group), and the AED operation performance was evaluated individually (Phase I test). At the 6-month follow-up AED performance test (Phase II test), half of the subjects were randomly switched to use another type of AED, which formed two switches (Switch A: AED1-1 group vs. AED2-1 group; Switch B: AED2-2 group vs. AED1-2 group).
RESULTS: A total of 224 college students participated in the study. In the phase I test, a significantly higher proportion of successful defibrillation and shorter shock delivery time to achieve successful defibrillation was observed in the AED2 group than in the AED1 group. In the phase II test, no statistical differences were observed in the proportion of successful defibrillation in Switch A (51.4% vs. 36.6%, P=0.19) and Switch B (78.0% vs. 53.7%, P=0.08). The median shock delivery time within participants achieving successful defibrillation was significantly longer in the switched group than that of the initial group in both Switch A (89 [81-107] s vs. 124 [95-135] s, P=0.006) and Switch B (68 [61.5-81.5] s vs. 95.5 [55-131] s, P<0.001).
CONCLUSION: College students were able to effectively use AEDs different from those used in the initial training after six months, although the time to shock delivery was prolonged.

Key words: Automated external defibrillator, Layperson, Cardiac arrest, Simulation

Chao-yu Lei, Heng-wei Qin, Xue-jie Dong, Jia-lin You, Lin Zhang. Layperson’s performance on an unconversant type of AED device: A prospective crossover simulation experimental study[J]. World Journal of Emergency Medicine, 2022, 13(2): 98-105.

Figures/Tables 4

Table 1

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Features		AED1	AED2
Power-on mechanism		On/off button inside of zippered box	On/off button outside of clamshell box
Pad design		Two-piece in an individual bag; Manually connected plug	One-piece; Pre-connected plug
Visual prompts		On pads, device, and handbook	On pads and device only; No handbook
Voice instructions
	Self-check	/	Units OK
	Response check	/	Check patient response
	Call for help	/	Call for help
	Pad placement	Place pads as figure shown. Insert the plug into the lighting socket. Place the pads and insert the plug (3 times). Place the pads and firmly press the plug.	Place the pads. (repeating every 8 s)
	Rhythm analysis	“Don’t touch the patient. Rhythm analysis in progression (twice).”	“Rhythm analysis in progression. Don’t touch the patient.”
	Defibrillation prompt	“Defibrillation recommended. Don’t touch the patient.”	“Defibrillation recommended. Charging now. Don’t touch the patient.”
	Shock delivery	“Press defibrillation button.” (button lighting and then sounding)	“Defibrillation now. Press the orange button.” (sounding and then button lighting)
	Resuming CPR	“Shock completed.” Pause “Start CPR if necessary.”	“Shock completed. Resume CPR please.” (compression tone sounding)

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