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.

Effectiveness of combining manual external defibrillator and automated external defibrillator training for third-year nurse students

Purpose:To assess the effectiveness of automated external defibrillator(AED)and manual external defibrillator(MED)training for third-year nurse students.Methods:We conducted post-demonstration and post-practice evaluation for MED defibrillation,and pre-training,post-demonstration,and post-practice evaluation for AED defibrillation.Results:Following MED training,time and confidence to defibrillate were improved significantly post-practice(p<0.001,p<0.001,respectively).In post-demonstration and postpractice evaluation,most students placed electrodes correctly(84.21%vs.80.70%),cleared before defibrillation(75.44%vs.89.47%),and performed cardiopulmonary resuscitation immediately after defibrillation(81.81%vs.94.44%);the evaluations were not statistically different(p=0.806,p=0.094,p=0.198,respectively).For AED training,time and confidence to defibrillate post-demonstration and post-practice were significantly improved(p<0.001 vs.p<0.001;p<0.001 vs.p<0.001,respectively)compared to that of pre-training;there was no obvious difference between the post-demonstration and postpractice evaluation(p=0.235,=0.346,respectively).Post-AED demonstration,most students could place electrodes correctly(85.96%),clear(91.23%),and perform CPR immediately after defibrillation(85.96%),which remained at a high level post-practice(94.74%,85.96%,82.46%,respectively);there was no significant difference between the two evaluations(p=0.203,p=0.557,p=0.776,respectively).Conclusion:Combining MED and AED defibrillation training is effective and feasible for third-year nurse students.Minimal training is effective for AED,while MED requires additional practice.

Comprehensive Analysis,Discussion and Suggestion on the Current Situation of Cardiopulmonary Resuscitation and Automatic External Defibrillator in General Public in China

The number of sudden cardiac death(SCD)has increased year by year,which has become one of the main causes of death in China.Timely cardiopulmonary resuscitation(CPR)and timely and accurate use of automatic external defibrillator(AED)can greatly improve the survival rate of patients with sudden cardiac death.Because the large probability of sudden cardiac death occurs outside the hospital,it is very important for the general public to master first aid skills.This paper will mine all kinds of data from multi-dimensional and multi-angle,analyze the mastery of public first aid skills in China,and provide practical suggestions and ideas for popularizing first aid skills in the future.

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

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.