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
Qiang Zhou1, Xuejie Dong2, Wei Zhang3, Rengyu Wu1, Kaizhu Chen1, Hongjuan Zhang1, Zhijie Zheng2, Lin Zhang4,5()
Received:
2022-10-28
Accepted:
2023-02-20
Online:
2023-06-30
Published:
2023-07-01
Contact:
Lin Zhang
E-mail:zhanglynn@sjtu.edu.cn
Qiang Zhou, Xuejie Dong, Wei Zhang, Rengyu Wu, Kaizhu Chen, Hongjuan Zhang, Zhijie Zheng, Lin Zhang. Effect of a low-cost instruction card for automated external defibrillator operation in lay rescuers: a randomized simulation study[J]. World Journal of Emergency Medicine, 2023, 14(4): 265-272.
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URL: http://wjem.com.cn/EN/10.5847/wjem.j.1920-8642.2023.070
Figure 1.
The illustration of AED self-instruction card in use. A: design of the AED self-instruction card; ① turn on AED immediately; ② fully bare the chest; ③ correctly place electrodes and then plug the connector into the AED; ④ keep clear when analyzing the rhythm and delivering shock and ⑤ click the button and resume CPR after shock. B: illustration of the placement of self-instruction card in the AED pocket.C: illustration of rescuer using AED with the self-instruction card in simulated cardiac arrest scenario. AED: automated external defibrillator; CPR: cardiopulmonary resuscitation.
Table 1.
Demographic characteristics of participants
Characteristics | Baseline and post-training | 3-month follow-up | |||||
---|---|---|---|---|---|---|---|
Card group (n=83) | Control group (n=82) | P-value | Card group (n=75) | Control group (n=77) | P-value | ||
Male, n (%) | 38 (45.8) | 37 (45.1) | 0.71 | 36 (48.0) | 36 (46.7) | 0.91 | |
Age group, n (%) | 0.89 | 0.78 | |||||
18-24 years | 30 (45.8) | 29 (35.4) | 29 (38.7) | 28 (36.4) | |||
25-54 years | 29 (34.9) | 30 (36.6) | 24 (32.0) | 29 (37.7) | |||
55-65 years | 24 (28.9) | 23 (28.0) | 22 (29.3) | 20 (26.0) | |||
Education status, n (%) | 0.26 | 0.19 | |||||
High school/ Junior college and below | 37 (44.6) | 27 (32.9) | 33 (44.0) | 26 (33.8) | |||
College/ University | 40 (48.2) | 44 (53.6) | 36 (48.0) | 42 (54.5) | |||
Master and above | 6 (7.2) | 11 (13.4) | 6 (8.0) | 9 (11.7) |
Table 2.
Comparison of laypeople AED operation skills between card group and control group, n (%)
Operation skills | Total | 18-24 years | 25-54 years | 55-65 years | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Card group | Control group | P-valuec | Card group | Control group | P-value | Card group | Control group | P-value | Card group | Control group | P-value | |||||
Fully baring the chest | ||||||||||||||||
Baseline a | 72 (88.9) | 52 (63.4) | <0.001 | 27 (90.0) | 24 (82.8) | 0.47 | 26 (89.7) | 22 (73.3) | 0.11 | 19 (79.2) | 6 (26.1) | <0.001 | ||||
Post-training a | 83 (100) | 82 (100) | - | 30 (100) | 29 (100) | - | 29 (100) | 30 (100) | - | 24 (100) | 23 (100) | - | ||||
Follow-up b | 61 (96.8) | 71 (92.2) | 0.29 | 29 (100) | 27 (96.4) | 0.49 | 12 (100) | 27 (93.1) | 1.0 | 20 (90.9) | 17 (85.0) | 0.66 | ||||
Correct electrodes placement | ||||||||||||||||
Baseline | 27 (32.5) | 14 (17.1) | 0.03 | 13 (43.3) | 9 (31.0) | 0.33 | 9 (31.0) | 3 (10.0) | 0.04 | 5 (20.8) | 2 (8.7) | 0.42 | ||||
Post-training | 63 (75.9) | 61 (74.4) | 0.82 | 25 (83.3) | 23 (79.3) | 0.69 | 22 (75.9) | 21 (70.0) | 0.61 | 16 (66.7) | 17 (73.9) | 0.59 | ||||
Follow-up | 37 (58.7) | 36 (46.8) | 0.16 | 18 (62.1) | 15 (53.6) | 0.52 | 7 (58.3) | 18 (62.1) | 1.0 | 12 (54.5) | 3 (15.0) | 0.01 | ||||
Clearing while AED analyzes the rhythm | ||||||||||||||||
Baseline | 70 (84.3) | 63 (76.8) | 0.22 | 27 (90.0) | 24 (82.8) | 0.47 | 23 (79.3) | 23 (76.7) | 0.81 | 20 (83.3) | 16 (69.6) | 0.32 | ||||
Post-training | 81 (97.6) | 74 (90.2) | 0.06 | 30 (100) | 25 (86.2) | 0.035 | 28 (96.6) | 28 (93.3) | 1.0 | 23 (95.8) | 21 (91.3) | 0.61 | ||||
Follow-up | 62 (98.4) | 71 (92.2) | 0.13 | 29 (100) | 25 (89.3) | 0.11 | 12 (100) | 29 (100) | - | 21 (95.5) | 17 (85.0) | 0.33 | ||||
Clearing while AED delivers the shock | ||||||||||||||||
Baseline | 78 (94.0) | 75 (91.5) | 0.57 | 28 (93.3) | 28 (96.6) | 1.0 | 28 (96.6) | 29 (96.7) | 1.0 | 22 (91.7) | 18 (78.3) | 0.25 | ||||
Post-training | 82 (98.8) | 81 (98.8) | 1.0 | 30 (100) | 29 (100) | - | 28 (96.6) | 30 (100) | 0.49 | 24 (100) | 22 (95.7) | 0.49 | ||||
Follow-up | 63 (100) | 74 (96.1) | 0.25 | 29 (100) | 28 (100) | - | 12 (100) | 29 (100) | - | 22 (100) | 17 (85.0) | 0.10 | ||||
Successful defibrillation d | ||||||||||||||||
Baseline | 26 (31.1) | 13 (15.9) | 0.03 | 13 (43.3) | 8 (27.6) | 0.21 | 8 (27.6) | 3 (10.0) | 0.08 | 5 (20.8) | 2 (8.7) | 0.42 | ||||
Post-training | 63 (75.9) | 61 (74.4) | 0.83 | 25 (83.3) | 23 (79.3) | 0.69 | 22 (75.9) | 21 (70.0) | 0.61 | 16 (66.7) | 17 (73.9) | 0.59 | ||||
Follow-up | 37 (58.7) | 36 (46.8) | 0.16 | 18 (62.1) | 15 (53.6) | 0.52 | 7 (58.3) | 18 (62.1) | 1.0 | 12 (54.5) | 3 (15.0) | 0.01 | ||||
Resuming CPR after shock | ||||||||||||||||
Baseline | 60 (72.3) | 8 (9.8) | <0.001 | 18 (60.0) | 3 (10.3) | <0.001 | 23 (79.3) | 3 (10.0) | <0.001 | 19 (79.2) | 2 (8.7) | <0.001 | ||||
Post-training | 83 (100) | 71 (86.6) | 0.001 | 30 (100) | 26 (89.7) | 0.11 | 29 (100) | 26 (86.7) | 0.11 | 24 (100) | 19 (82.6) | 0.13 | ||||
Follow-up | 62 (98.4) | 44 (57.1) | <0.001 | 29 (100) | 20 (71.4) | 0.002 | 12 (100) | 21 (72.4) | 0.08 | 21 (95.5) | 3 (15.0) | <0.001 |
Table 3.
Comparison of time intervals in successful defibrillation between card group and control group by age, s, M(P25-P75)
Variables | Total | 18-24 years | 25-54 years | 55-65 years | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Card group | Control group | P-value | Card group | Control group | P-value | Card group | Control group | P-value | Card group | Control group | P-value | |||||||||||||
n | Time intervals | n | Time intervals | n | Time intervals | n | Time intervals | n | Time intervals | n | Time intervals | n | Time intervals | n | Time intervals | |||||||||
Time to power-on a | ||||||||||||||||||||||||
Baseline | 26 | 35 (18-89) | 13 | 51 (17-107) | 0.79 | 13 | 74 (34-109) | 8 | 80 (42-172) | 0.45 | 8 | 21 (14-78) | 3 | 23 (12-72) | 0.83 | 5 | 18 (10-30) | 2 | 18, 39 | 0.33 | ||||
Post-training | 63 | 28 (11-48) | 61 | 22 (11-51) | 0.96 | 25 | 36 (16-50) | 23 | 29 (11-52) | 0.48 | 22 | 34 (17-44) | 21 | 17 (9-43) | 0.08 | 16 | 9 (6-14) | 17 | 33 (12-58) | 0.019 | ||||
Follow-up | 37 | 36 (17-52) | 36 | 28 (16-50) | 0.49 | 18 | 40 (20-52) | 15 | 31 (19-53) | 0.72 | 7 | 54 (35-71) | 18 | 31 (17-50) | 0.07 | 12 | 27 (9-38) | 3 | 15 (10-31) | 0.67 | ||||
Time to shock a | ||||||||||||||||||||||||
Baseline | 26 | 113 (92-146) | 13 | 107 (101-131) | 0.25 | 13 | 125 (113-171) | 8 | 129 (103-198) | 0.72 | 8 | 91 (80-140) | 3 | 109 (102-122) | 0.38 | 5 | 95 (72-112) | 2 | 85, 92 | 1 | ||||
Post-training | 63 | 72 (63-78) | 61 | 80 (69-88) | <0.001 | 25 | 75 (66-80) | 23 | 74 (64-88) | 0.59 | 22 | 68 (63-78) | 21 | 81 (70-90) | 0.009 | 16 | 65 (56-74) | 17 | 79 (77-86) | 0.001 | ||||
Follow-up | 37 | 74 (66-87) | 36 | 80 (71-94) | 0.05 | 18 | 76 (68-83) | 15 | 81 (69-92) | 0.31 | 7 | 100 (77-143) | 18 | 78 (69-93) | 0.05 | 12 | 68 (60-74) | 3 | 92 (75-106) | 0.006 | ||||
Time to resume CPR after shock b | ||||||||||||||||||||||||
Baseline | 23 | 10 (7-13) | 5 | 12 (11-15) | 0.06 | 10 | 8 (5-13) | 2 | 10, 11 | 0.39 | 8 | 13 (10-14) | 2 | 12, 15 | 0.60 | 5 | 8 (5-10) | 1 | 16 | 0.14 | ||||
Post-training | 63 | 7 (3-10) | 51 | 10 (8-11) | <0.001 | 25 | 4 (2-8) | 16 | 9 (6-10) | 0.003 | 22 | 10 (6-11) | 21 | 9.5 (8-11) | 0.87 | 16 | 6 (3-9) | 14 | 10 (7-12) | 0.002 | ||||
Follow-up | 36 | 9 (8-12) | 27 | 9 (7-12) | 0.33 | 18 | 11 (9-14) | 10 | 8 (6-19) | 0.36 | 7 | 9 (8-16) | 16 | 9 (8-12) | 0.66 | 11 | 9 (8-10) | 1 | 9 | 0.88 |
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