OBJECTIVE: Our study evaluates the impact of features of automated external defibrillators (AEDs) on the performance and speed of untrained laypersons to deliver a shock and initiate CPR after a shock. METHODS: This was a randomized trial of volunteer laypersons without AED or advanced medical training. Subjects were assigned to use one of six different models of AEDs on a manikin in simulated cardiac arrest. No instructions on AED operation were provided. Primary endpoints were shock delivery and elapsed time from start to shock. Secondary endpoints included time to power-on, initiation of CPR, adequacy of pad placement and subjects' ratings of ease of use (1=very easy, 5=very difficult). RESULTS: Most subjects (109/120; 91%) were able to deliver a shock. Median time from start of scenario to shock delivery was 79 s (IQR: 67-99). Of the 11 participants who did not deliver shock, eight never powered on the device. Time to power-on was shorter in devices with open lid (median 12s, IQR 8-27 s) and pull handle (17s, IQR 9-20s) mechanisms than with a push button (37s, IQR 18-69 s; p=0.000). Pad position on the manikin was judged adequate for 86 (77%) of the 111 subjects who placed pads. Devices which gave more detailed voice instruction for pad placement had higher rates of adequate pad position [38/39 (97%) versus 50/73 (68%), p=0.001]. With AEDs that provided step-by-step CPR instruction, 49/58 (84%) subjects began CPR compared to 26/51 (51%) with AEDs that only prompted to start CPR (p=0.01). Participants rated all the models easy to use (overall mean 1.48; individual device means 1.28-1.71). CONCLUSIONS: Most untrained laypersons were successful in delivering a shock. Device features had the most impact on these functions: ability and time to power-on device, adequacy of pad position and initiation of CPR.
RCT Entities:
OBJECTIVE: Our study evaluates the impact of features of automated external defibrillators (AEDs) on the performance and speed of untrained laypersons to deliver a shock and initiate CPR after a shock. METHODS: This was a randomized trial of volunteer laypersons without AED or advanced medical training. Subjects were assigned to use one of six different models of AEDs on a manikin in simulated cardiac arrest. No instructions on AED operation were provided. Primary endpoints were shock delivery and elapsed time from start to shock. Secondary endpoints included time to power-on, initiation of CPR, adequacy of pad placement and subjects' ratings of ease of use (1=very easy, 5=very difficult). RESULTS: Most subjects (109/120; 91%) were able to deliver a shock. Median time from start of scenario to shock delivery was 79 s (IQR: 67-99). Of the 11 participants who did not deliver shock, eight never powered on the device. Time to power-on was shorter in devices with open lid (median 12s, IQR 8-27 s) and pull handle (17s, IQR 9-20s) mechanisms than with a push button (37s, IQR 18-69 s; p=0.000). Pad position on the manikin was judged adequate for 86 (77%) of the 111 subjects who placed pads. Devices which gave more detailed voice instruction for pad placement had higher rates of adequate pad position [38/39 (97%) versus 50/73 (68%), p=0.001]. With AEDs that provided step-by-step CPR instruction, 49/58 (84%) subjects began CPR compared to 26/51 (51%) with AEDs that only prompted to start CPR (p=0.01). Participants rated all the models easy to use (overall mean 1.48; individual device means 1.28-1.71). CONCLUSIONS: Most untrained laypersons were successful in delivering a shock. Device features had the most impact on these functions: ability and time to power-on device, adequacy of pad position and initiation of CPR.
Authors: Eric Goralnick; Muhammad A Chaudhary; Justin C McCarty; Edward J Caterson; Scott A Goldberg; Juan P Herrera-Escobar; Meghan McDonald; Stuart Lipsitz; Adil H Haider Journal: JAMA Surg Date: 2018-09-01 Impact factor: 14.766
Authors: Justin C McCarty; Zain G Hashmi; Juan P Herrera-Escobar; Elzerie de Jager; Muhammad Ali Chaudhary; Stuart R Lipsitz; Molly Jarman; Edward J Caterson; Eric Goralnick Journal: JAMA Surg Date: 2019-10-01 Impact factor: 14.766
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Authors: Line Zinckernagel; Carolina Malta Hansen; Morten Hulvej Rod; Fredrik Folke; Christian Torp-Pedersen; Tine Tjørnhøj-Thomsen Journal: BMC Emerg Med Date: 2017-01-19
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Authors: Carolina Malta Hansen; Simone Mørk Rosenkranz; Fredrik Folke; Line Zinckernagel; Tine Tjørnhøj-Thomsen; Christian Torp-Pedersen; Kathrine B Sondergaard; Graham Nichol; Morten Hulvej Rod Journal: J Am Heart Assoc Date: 2017-03-13 Impact factor: 5.501