Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Resuscitation. 2009 Nov;80(11):1285-9. doi: 10.1016/j.resuscitation.2009.07.016. Epub 2009 Aug 31.
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.
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).
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).
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.
本研究评估了自动体外除颤器（AED）的特征对未经培训的非专业人员在电击后进行电击和启动心肺复苏（CPR）的操作性能和速度的影响。
这是一项针对无 AED 或高级医疗培训的志愿者非专业人员的随机试验。受试者被分配在模拟心搏骤停的人体模型上使用六种不同型号的 AED 之一。未提供有关 AED 操作的说明。主要终点是电击的实施和从开始到电击的时间。次要终点包括开机时间、CPR 的启动、电极片放置的充分性以及受试者对易用性的评分（1=非常容易，5=非常困难）。
大多数受试者（120 名中的 109 名；91%）能够实施电击。从场景开始到电击实施的中位数时间为 79 秒（IQR：67-99）。在 11 名未能实施电击的参与者中，有 8 名从未打开设备。具有开盖（中位时间 12 秒，IQR 8-27 秒）和拉手柄（17 秒，IQR 9-20 秒）机制的设备的开机时间短于具有按钮（37 秒，IQR 18-69 秒；p=0.000）的设备。在放置电极片的 111 名受试者中，有 86 名（77%）认为电极片位置合适。提供更详细的电极片放置语音指导的设备具有更高的合适电极片位置率[38/39（97%）与 50/73（68%），p=0.001]。在提供分步 CPR 指导的 AED 中，有 49/58（84%）名受试者开始进行 CPR，而在仅提示开始 CPR 的 AED 中，有 26/51（51%）名受试者开始进行 CPR（p=0.01）。参与者对所有模型的易用性评价均为容易（总体平均 1.48；个别设备平均值 1.28-1.71）。
大多数未经培训的非专业人员都成功实施了电击。设备特征对这些功能的影响最大：设备的开启能力和时间、电极片位置的充分性和 CPR 的启动。
