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World Journal of Emergency Medicine ›› 2023, Vol. 14 ›› Issue (4): 265-272.doi: 10.5847/wjem.j.1920-8642.2023.070

• Original Article • Previous Articles     Next Articles

Effect of a low-cost instruction card for automated external defibrillator operation in lay rescuers: a randomized simulation study

Qiang Zhou1, Xuejie Dong2, Wei Zhang3, Rengyu Wu1, Kaizhu Chen1, Hongjuan Zhang1, Zhijie Zheng2, Lin Zhang4,5()   

  1. 1Shenzhen Emergency Medical Center, Shenzhen 518035, China
    2Department of Global Health, School of Public Health, Peking University, Beijing 100083, China
    3Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    4School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
    5School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
  • Received:2022-10-28 Accepted:2023-02-20 Online:2023-06-30 Published:2023-07-01
  • Contact: Lin Zhang


BACKGROUND: To evaluate whether a simplified self-instruction card can help potential rescue providers use automated external defibrillators (AEDs) more accurately and quickly.
METHODS: From June 1, 2018, to November 30, 2019, a prospective longitudinal randomized controlled simulation study was conducted among 165 laypeople (18-65 years old) without prior AED training. A self-instruction card was designed to illuminate key AED operation procedures. Subjects were randomly divided into the card (n=83) and control (n=82) groups with age stratification. They were then individually evaluated in the same simulated scenario to use AED with (card group) or without the self-instruction card (control group) at baseline, post-training, and at the 3-month follow-up.
RESULTS: At baseline, the card group reached a significantly higher proportion of successful defibrillation (31.1% vs. 15.9%, P=0.03), fully baring the chest (88.9% vs. 63.4%, P<0.001), correct electrode placement (32.5% vs. 17.1%, P=0.03), and resuming cardiopulmonary resuscitation (CPR) (72.3% vs. 9.8%, P<0.001). At post-training and follow-up, there were no significant differences in key behaviors, except for resuming CPR. Time to shock and time to resume CPR were shorter in the card group, while time to power-on AED was not different in each phase of tests. In the 55-65 years group, the card group achieved more skill improvements over the control group compared to the other age groups.
CONCLUSION: The self-instruction card could serve as a direction for first-time AED users and as a reminder for trained subjects. This could be a practical, cost-effective way to improve the AED skills of potential rescue providers among different age groups, including seniors.

Key words: Automated external defibrillator, Laypeople, Skill, Instruction card, Simulation