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

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,posttraining,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.