Monsieurs Koenraad G, Vogels Catherine, Bossaert Leo L, Meert Philippe, Calle Paul A
Emergency Department, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium.
Resuscitation. 2005 Jan;64(1):41-7. doi: 10.1016/j.resuscitation.2004.07.003.
Current international guidelines prefer the use of semi-automatic external defibrillators (SAEDs) over fully automatic external defibrillators (FAEDs). However, there is a lack of evidence supporting this recommendation. We conducted a study of usability with nursing students comparing the FAED version against the SAED version of the Lifepak CR Plus AED (Medtronic, Redmond, USA). We hypothesized that FAED use would limit the number of operator-device interactions, thereby increasing compliance by the rescuer, safety and speed.
Sixty-two untrained first year nursing students were randomized to use the FAED or the SAED in a simulated cardiac arrest scenario. During analysis and delivery of three shocks, the AED guided the user with six voice prompts per shock (18 voice prompts per student). Their performance with regard to efficacy and safety was assessed using video recording.
All rescuers except for two were able to attach electrodes and deliver a series of three shocks. During rhythm analysis by the device, FAED users made 30/372 (8%) errors against 62/360 (17%) errors for SAED users (P < 0.001). During shock delivery, FAED users made 0/186 errors against 12/180 (7%) for SAED users (P < 0.001). FAED use eliminated long time intervals between the first to the third shock (range 47-49s for FAED versus 41-90s for SAED).
Despite a lack of BLS skills and AED training, the majority of students demonstrated safe and effective use of the AED. The use of the FAED version of the CR Plus resulted in increased compliance with the protocol and reduced variability in time to deliver three shocks. Further research is needed to confirm these findings in other groups of first responders.
当前国际指南更倾向于使用半自动体外除颤器（SAED）而非全自动体外除颤器（FAED）。然而，缺乏支持这一建议的证据。我们对护理专业学生进行了一项可用性研究，比较了菲康CR Plus自动体外除颤器（美国美敦力公司，雷德蒙德）的FAED版本和SAED版本。我们假设使用FAED会减少操作者与设备的交互次数，从而提高施救者的依从性、安全性和速度。
62名未受过训练的一年级护理专业学生被随机分配在模拟心脏骤停场景中使用FAED或SAED。在分析和给予三次电击期间，除颤器每次电击用六个语音提示引导用户（每名学生共18个语音提示）。通过录像评估他们在有效性和安全性方面的表现。
除两名施救者外，所有施救者都能够连接电极并给予一系列三次电击。在设备进行心律分析期间，FAED用户出现30/372（8%）次错误，而SAED用户出现62/360（17%）次错误（P<0.001）。在电击给予期间，FAED用户出现0/186次错误，而SAED用户出现12/180（7%）次错误（P<0.001）。使用FAED消除了第一次电击到第三次电击之间的长时间间隔（FAED为47 - 49秒，而SAED为41 - 90秒）。
尽管缺乏基础生命支持技能和除颤器培训，但大多数学生展示了安全有效的除颤器使用。使用CR Plus的FAED版本提高了对操作流程的依从性，并减少了给予三次电击的时间差异。需要进一步研究以在其他急救人员群体中证实这些发现。
